Hidden mortality rate associated with extracorporeal membrane oxygenation

Boedy, R. F.; Howell, Charles G.; Kanto, William P.

doi:10.1016/s0022-3476(05)81098-4

Cited by 63 publications

(26 citation statements)

References 6 publications

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“…The term 'hidden mortality' has been used to Type not reported describe the death of a patient who meets the criteria for ECMO or other rescue therapy, but expires before the treatment is initiated. 20 We found very little 'hidden mortality.' Of the 88 patients who died, most of them (n ¼ 64) had a major anomaly, a history of hypoxic-ischemic injury, or another complication that would have been a contraindication to ECMO.…”

Section: Discussionmentioning

confidence: 77%

Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period

Clark²,

et al. 2009

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Objective: The purpose of this study was to evaluate the demographic and treatment characteristics of neonates (X37 weeks' estimated gestational age) who were admitted to a neonatal intensive care unit (NICU) for a diagnosis of meconium aspiration syndrome (MAS) during the years 1997 to 2007. The goals in studying this group of neonates were to better estimate the magnitude of abnormal outcomes and to determine the proportion of these infants exposed to specific therapeutic interventions.Study Design: Retrospective review of an administrative de-identified data set.Result: A total of 415 772 neonates formed the starting data set and 162 075 (39%) were X37 weeks. Of the 162 075 term neonates, 7518 (1.8% of all neonates and 4.6% of term NICU admissions) had an admission diagnosis of MAS. In the 7518 neonates, the following outcomes were observed: 6124 (81.5%) were discharged home; 679 (9%) were acutely transferred to a higher level of intensive care; 416 (5.5%) were transferred to another clinical service within the hospital; 178 (2.4%) were transferred to another NICU for convalescent care and 88 (1.2%) died. There were 33 (0.4%) who did not have data on outcome at discharge. During the period between 2002 and 2005, acute transfer rates decreased (12.4 to 9%) and the reported rate for death remained relatively constant between 0.9 and 1.5%. There were 107 (1.4%) neonates who were treated (n ¼ 61) with, or transferred, for extracorporeal membrane oxygenation (ECMO) (n ¼ 46). Three of the sixty-one neonates (4.9%) who were treated with ECMO died. Conclusion:Term neonates who are admitted with a diagnosis of MAS continue to represent a high-risk population with significant morbidity, and they often require intensive therapies.

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Section: Discussionmentioning

confidence: 77%

Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period

Clark²,

et al. 2009

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“…The technique has developed at ECMO referral centers in response to the need to transport a subset of individuals in severe pulmonary or cardiac failure. These individuals may benefit from ECMO bypass but die before leaving the referring facility because they are too sick to tolerate transportation [15]. In addition, transport ECMO is needed for individuals started on ECMO in one center, but in need of therapy provided at a different location, such as cardiac or pulmonary transplantation.…”

Section: Discussionmentioning

confidence: 99%

A 22-year experience in global transport extracorporeal membrane oxygenation

Coppola

Tyree

Larry

et al. 2008

Journal of Pediatric Surgery

109

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“…In a study of infants who were referred for management at an ECMO centre, 19/158 (12%) died prior to or during conventional transportation [21]. Establishing ECMO at the referring hospital may decrease the risk of transporting patients with severe ARDS compared with conventional retrieval, as transport ventilators are less accurate than ICU ventilators (especially when airway resistance is high) [22,23], while even in a pressurised aircraft cabin, the inspired partial pressure of oxygen will fall by 25% at normal flight altitude [24].…”

Section: Ecmo Retrievalmentioning

confidence: 99%

Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience

Forrest

Ratchford

Burns³

et al. 2011

Intensive Care Med

119

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Patients with very severe respiratory failure, which was considered to preclude conventional ventilation for safe transfer to tertiary centres, were managed by an ECMO referral and retrieval program in NSW and had a high rate of survival. This program also enhanced the capacity of the state to respond to a surge in demand for ECMO support due to the H1N1 epidemic, although the role of ECMO in respiratory failure is not yet well defined.

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Hidden mortality rate associated with extracorporeal membrane oxygenation

Cited by 63 publications

References 6 publications

Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period

Meconium aspiration syndrome remains a significant problem in the NICU: outcomes and treatment patterns in term neonates admitted for intensive care during a ten-year period

A 22-year experience in global transport extracorporeal membrane oxygenation

Retrieval of critically ill adults using extracorporeal membrane oxygenation: an Australian experience

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