C. C. Bennett, A. Johnson, D. J. Field
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
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.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 30, 06/2002
Pages: 225 - 230
Show full article (external site)
Show all available items of this journal
Search
