PT  - JOURNAL ARTICLE
AU  - Marjolein Spoel
AU  - Roxanne Laas
AU  - Saskia J Gischler
AU  - Wim JC Hop
AU  - Dick Tibboel
AU  - Johan C de Jongste
AU  - Hanneke IJsselstijn
TI  - Diagnosis-related deterioration of lung function after extracorporeal membrane oxygenation
AID  - 10.1183/09031936.00189911
DP  - 2012 Jan 01
TA  - European Respiratory Journal
PG  - erj01899-2011
4099  - http://erj.ersjournals.com/content/early/2012/04/05/09031936.00189911.short
4100  - http://erj.ersjournals.com/content/early/2012/04/05/09031936.00189911.full
AB  - To assess lung function longitudinally after neonatal ECMO, and to identify any effects of diagnosis and perinatal characteristics.121 neonatal ECMO-treated children (70 meconium aspiration syndrome, 20 congenital diaphragmatic hernia, 31 other diagnoses) performed altogether 191 lung function measurements at 5, 8 and/or 12 years. We assessed dynamic and static lung volumes, reversibility of airway obstruction and diffusion capacity.Mean SDS FEV1 at 5 years 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 years (−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 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 FVC 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.