RT Journal Article
SR Electronic
T1 Diagnosis-related deterioration of lung function after extracorporeal membrane oxygenation
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1531
OP 1537
DO 10.1183/09031936.00189911
VO 40
IS 6
A1 Marjolein Spoel
A1 Roxanne Laas
A1 Saskia J. Gischler
A1 Wim J.C. Hop
A1 Dick Tibboel
A1 Johan C. de Jongste
A1 Hanneke Ijsselstijn
YR 2012
UL http://erj.ersjournals.com/content/40/6/1531.abstract
AB The aim of the study was to assess lung function longitudinally after neonatal extracorporeal membrane oxygenation (ECMO), and to identify any effects of diagnosis and perinatal characteristics. 121 neonatal ECMO-treated children (70 with meconium aspiration syndrome, 20 congenital diaphragmatic hernia and 31 with other diagnoses) performed a total of 191 lung function measurements at 5, 8 and/or 12 yrs. We assessed dynamic and static lung volumes, reversibility of airway obstruction and diffusion capacity. Mean SDS forced expiratory volume in 1 s (FEV1) at 5 yrs before and after bronchodilation (-0.51 and 0.07) was significantly higher than at 8 (-0.79 and -0.4; p<0.04) and 12 yrs (-1.10 and -0.52; p<0.003). Mean SDS for all spirometric parameters before and after bronchodilation were significantly lower in the congenital diaphragmatic hernia group compared with the other diagnostic groups (all p≤0.025). A significant volume of trapped air was observed in 86% patients with congenital diaphragmatic hernia, 50% with meconium aspiration syndrome and 58% with other diagnoses. After bronchodilation, mean SDS FEV1 and forced vital capacity were negatively influenced by duration of ventilation (both p<0.001) and duration of ECMO (p=0.003 and p=0.02, respectively). Long-term pulmonary sequelae after neonatal ECMO-treatment mainly occur in congenital diaphragmatic hernia patients and tend to deteriorate over time.