Premium
Continued pulmonary recovery observed after discontinuing extracorporeal membrane oxygenation
Author(s) -
Antunes Michael J.,
Cullen James A.,
Holt William J.,
Gauthier Theresa W.,
Baumgart Stephen,
Greenspan Jay S.
Publication year - 1994
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950170302
Subject(s) - medicine , extracorporeal membrane oxygenation , oxygenation , intensive care medicine , anesthesia
Extracorporeal membrane oxygenation (ECMO) is a valuable therapy for the treatment of reversible lung disease in neonates. Associated with this treatment, however, are risks for complications that increase with the duration of therapy. We evaluated alveolar‐arterial oxygen tension difference P (A‐a)O 2pulmonary compliance (C L ), and functional residual capacity (FRC) in 20 infants immediately after ECMO was discontinued, and again 24 hours thereafter. We measured C, by pnemotachography and eosphageal manometry and FRC by helium dilution. Mean (±SEM) values for C L and FRC increased (C L from 0.28 ± 0.02 to 0.35 ± 0.03 mL/cmH 2 O)/kg and FRC from 18.6 ± 1.4 to 22.2 ± 1.1 mL/kg; P < 0.05), and P (A‐a)o 2and the oxygenation index (OI) decreased (200 ± 19 to 169 ± 14 mm Hg and 6.9 ± 0.44 to 5.4 ± 0.5, respectively; P < 0.02), over the 24 hour period following ECMO. Nineteen of 20 infants experienced improvement in at least two of these parameters. Improvements were found to be greatest in the infant with the worst lung function immediately after discontinuing ECMO, and in the ten infants who had not received pancuronium bromide for inducing skeletal muscle paralysis, following decannulation from ECMO. These data indicate that improvement in lung function following ECMO will generally continue over the 24 hour period following the termination of cardiopulmonary bypass, and that borderline pulmonary status may not preclude discontinuation of bypass therapy. Pediatr Pulmonol. 1994; 17:143–148. © 1994 Wiley‐Liss, Inc.