A comparison of clinical variables that predict adverse outcome in term infants with severe respiratory failure randomised to a policy of extracorporeal membrane oxygenation or to conventional neonatal intensive care
-
C. C. Bennett
Abstract
Objective: To identify clinical variables predicting adverse outcome in a group of infants with severe respiratory failure who were randomized either to referral for extra-corporeal membrane oxygenation (ECMO) or to conventional neonatal intensive care within the United Kingdom.
Methods: Adverse outcome was defined by death or disability by four years of age. Receiver operator characteristic (ROC) plots were constructed for variables with continuous data and relative risk (RR) with 95% confidence intervals (CI) calculated for binominal data.
Results: Of variables measurable at trial entry, congenital diaphragmatic hernia and lower birthweight was also associated with increased mortality and morbidity. Seizures or supplementary oxygen at discharge were markers of disease course, which predicted a poorer outcome amongst survivors. These variables behaved similarly in the two trial groups. Those infants in the ECMO group with an episode of sepsis, established full sucking feeds after 14 days of age or a hospital stay over 30 days were at increased risk of disability.
Conclusions: This study has identified clinical variables that predict adverse outcome for term infants with severe respiratory failure. The results may assist clinicians caring for these babies, when counseling their families and in the development of guidelines for neonatal ECMO.
Copyright © 2002 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- Cutaneous and subcutaneous infections in newborns due to anaerobic bacteria
- Repeated prenatal corticosteroids reduce glial fibrillary acidic protein in the ovine central nervous system
- Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable? – A blinded controlled audit
- A comparison of clinical variables that predict adverse outcome in term infants with severe respiratory failure randomised to a policy of extracorporeal membrane oxygenation or to conventional neonatal intensive care
- Experience with first level ultrasound and echocardiography for a selected and an unselected population
- Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy
- The midwife factor in obstetric procedures and neonatal outcome
- Cerebral intracellular calcium concentrations in asphyxiated rat fetuses resuscitated with oxygen
- V-shaped deceleration differs in the pattern of carotid blood flow from variable deceleration provoked by cord compression
- Sudden intractable respiratory failure in extremely low birth weight infants with H-type tracheoesophageal fistula
- Neuropathological features of the brain in acardius acormus
- Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome
- Congress Calendar
- WAPM-Newsletter No 1/2002
Articles in the same Issue
- Cutaneous and subcutaneous infections in newborns due to anaerobic bacteria
- Repeated prenatal corticosteroids reduce glial fibrillary acidic protein in the ovine central nervous system
- Are intrapartum and neonatal deaths in breech delivery at term potentially avoidable? – A blinded controlled audit
- A comparison of clinical variables that predict adverse outcome in term infants with severe respiratory failure randomised to a policy of extracorporeal membrane oxygenation or to conventional neonatal intensive care
- Experience with first level ultrasound and echocardiography for a selected and an unselected population
- Fetal superior mesenteric artery blood flow velocimetry in normal and high-risk pregnancy
- The midwife factor in obstetric procedures and neonatal outcome
- Cerebral intracellular calcium concentrations in asphyxiated rat fetuses resuscitated with oxygen
- V-shaped deceleration differs in the pattern of carotid blood flow from variable deceleration provoked by cord compression
- Sudden intractable respiratory failure in extremely low birth weight infants with H-type tracheoesophageal fistula
- Neuropathological features of the brain in acardius acormus
- Transient postpartum diabetes insipidus in twin pregnancy associated with HELLP syndrome
- Congress Calendar
- WAPM-Newsletter No 1/2002
