• Pediatr Crit Care Me · Mar 2024

    Pao2 and Mortality in Neonatal Extracorporeal Membrane Oxygenation: Retrospective Analysis of the Extracorporeal Life Support Organization Registry, 2015-2020.

    • Orlane Brohan, Alexis Chenouard, Aurélie Gaultier, Joseph E Tonna, Peter Rycus, Stefano Pezzato, Andrea Moscatelli, Jean-Michel Liet, Pierre Bourgoin, RozéJean-ChristopheJCPediatric Intensive Care Unit, University Hospital of Nantes, Nantes, France.Clinical Investigation Center (CIC) 1413, INSERM, Public Health, Clinic of the Data, University Hospital of Nantes, Nantes, France., Pierre-Louis Léger, Jérôme Rambaud, and Nicolas Joram.
    • Pediatric Intensive Care Unit, University Hospital of Nantes, Nantes, France.
    • Pediatr Crit Care Me. 2024 Mar 21.

    ObjectivesExtracorporeal life support can lead to rapid reversal of hypoxemia but the benefits and harms of different oxygenation targets in severely ill patients are unclear. Our primary objective was to investigate the association between the Pao2 after extracorporeal membrane oxygenation (ECMO) initiation and mortality in neonates treated for respiratory failure.DesignRetrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry data, 2015-2020.PatientsNewborns supported by ECMO for respiratory indication were included.InterventionsNone.Measurements And Main ResultsPao2 24 hours after ECMO initiation (H24 Pao2) was reported. The primary outcome was 28-day mortality. We identified 3533 newborns (median age 1 d [interquartile range (IQR), 1-3]; median weight 3.2 kg [IQR, 2.8-3.6]) from 198 ELSO centers, who were placed on ECMO. By 28 days of life, 731 (20.7%) had died. The median H24 Pao2 was 85 mm Hg (IQR, 60-142). We found that both hypoxia (Pao2 < 60 mm Hg) and moderate hyperoxia (Pao2 201-300 mm Hg) were associated with greater adjusted odds ratio (aOR [95% CI]) of 28-day mortality, respectively: aOR 1.44 (95% CI, 1.08-1.93), p = 0.016, and aOR 1.49 (95% CI, 1.01-2.19), p value equals to 0.045.ConclusionsEarly hypoxia or moderate hyperoxia after ECMO initiation are each associated with greater odds of 28-day mortality among neonates requiring ECMO for respiratory failure.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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