Surfactant replacement therapy on ECMO does not improve outcome in neonates with congenital diaphragmatic hernia1
Section snippets
Materials and methods
An invitation to contribute to a CDH registry (Appendix) was sent to all ECMO centers and to members of the American Pediatric Surgical Association, the Society for Pediatric Research, and the Perinatal Section of the American Academy of Pediatrics. Centers collected data on all liveborn infants with CDH beginning January 1, 1995. There were 83 centers in North America, Europe, and Australia who participated in the registry. Data were collected until death or discharge from the hospital. These
Demographic and clinical variables
There were no significant differences in demographic variables between the 2 groups. Then mean birth weight, estimated gestational age (EGA), and hours from birth until ECMO cannulation were similar between groups. The percentage of patients who were inborn at an ECMO center, were male, had 1- or 5-minute Apgar scores of ≤3, were prenatally diagnosed, or had a left-sided defect was similar between groups. Subgroup analyses by gestational age found no differences between group 1 (−Surf) and
Discussion
This analysis of CDH Study Group Registry data finds no significant difference in survival, length of ECMO run, days intubated or oxygen use at 30 days, or discharge in surfactant-versus nonsurfactant-treated groups. These results suggest that at least 1 dose of surfactant on ECMO does not afford a significant improvement in any of the outcome measures. We demonstrated in this large, multicenter, retrospective review that the patients in the surfactant-treated and nonsurfactant-treated groups
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This manuscript was prepared by the following investigators who assume responsibility for the overall content: Christopher E. Colby, Kevin P. Lally, Susan R. Hintz, Pamela A. Lally, Dick Tibboel, Fernando R. Moya, and Krisa P. VanMeurs.