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Pediatr Crit Care Me · Jan 2017
Multicenter StudyAdult Outcomes After Newborn Respiratory Failure Treated With Extracorporeal Membrane Oxygenation.
- William A Engle, Karen W West, Gail A Hocutt, Eugenia K Pallotto, Barbara Haney, Rachel J Keith, Dan L Stewart, Ellen Knodel, Denise Suttner, Rachel Chapman, Alison Thomas, Beverly Schwerin, Eileen Stork, Moira Crowley, Anthony J Piazza, Micheal L Heard, Netsanet Gebregziabher, William Fadel, and Robert Bartlett.
- 1Section of Neonatal Perinatal Medicine, Department of Pediatrics, Riley Hospital for Children, Indianapolis, IN.2Department of Pediatric Surgery, Riley Hospital for Children, Indianapolis, IN.3Department of Nursing, Riley Hospital for Children, Indianapolis, IN.4Division of Neonatology, Children's Mercy Hospital, Kansas City, MO.5Cardiovascular Medicine, Kosair Children's Hospital, Louisville, KY.6Neonatal Medicine, Kosair Children's Hospital, Louisville, KY.7Division of Neonatology, Rady Children's Hospital San Diego, San Diego, CA.8Division of Neonatology, Rady Children's Hospital San Diego, San Diego, CA.9Department of Nursing, Huntington Hospital, Pasadena, CA.10Division of Neonatology, Case Western Reserve, Cleveland, OH.11Section of Neonatology, Emory University, Children's Healthcare of Atlanta, Atlanta, GA.12Division of Pediatric Critical Care and ECMO Center, Children's Healthcare of Atlanta, Atlanta, GA.13Department of Biostatistics, Indiana University School of Medicine, Indiana University Purdue University Indianapolis, Indianapolis, IN.14Department of Surgery, Section of General Surgery, Division of Acute Care Surgery, Mott Children's Hospital, Ann Arbor, MI.
- Pediatr Crit Care Me. 2017 Jan 1; 18 (1): 73-79.
ObjectiveTo describe the outcome of young adults treated for hypoxemic respiratory failure with extracorporeal membrane oxygenation as neonates.DesignThe study was designed as a multisite, cross sectional survey.SettingThe survey was completed electronically or on paper by subjects and stored in a secure data base.SubjectsSubjects were surviving neonatal extracorporeal membrane oxygenation patients from eight institutions who were18 years old or older.InterventionsNone.Measurements And Main ResultsA questionnaire modified from the 2011 Behavioral Risk Factor Surveillance System and the 2011 National Health Interview Survey with additional unique questions was completed by subjects. Results were compared to age-matched national Behavioral Risk Factor Surveillance System and National Health Interview Survey data. One hundred and forty-six subjects participated (8.9% of eligible candidates). The age at questionnaire submission was 23.7 ± 2.89 years. Subjects differed statistically from national cohorts by being more satisfied with life (93% vs 84.2%); more educated (some college or degree; 80.1% vs 57.7%); more insured for healthcare (89.7% vs 72.3%); less frequent users of healthcare in the last 12 months (47.3% vs 58.2%); more limited because of physical, mental, and developmental problems (19.9% vs 10.9%); and having more medical complications. Furthermore, learning problems occurred in 29.5% of the study cohort. The congenital diaphragmatic hernia group was generally less healthy and less well educated, but equally satisfied with life. Perinatal variables contributed little to outcome prediction.ConclusionsMost young adult survivors in this study cohort treated with extracorporeal membrane oxygenation as neonates are satisfied with their lives, working and/or in college, in good health and having families. These successes are occurring despite obstacles involving health issues such as asthma, attention deficit disorder, learning difficulties, and vision and hearing problems; this is especially evident in the congenital diaphragmatic hernia cohort. Selection bias inherent in such a long-term study may limit generalizability, and it is imperative to note that our sample may not be representative of the whole.
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