TY - JOUR
T1 - Current Practices for Genetic Testing in Neonatal Extracorporeal Membrane Oxygenation
T2 - Findings from a National survey
AU - Children's Hospitals Neonatal Consortium (CHNC)
AU - Wild, K. Taylor
AU - Miquel-Verges, Franscesca
AU - Rintoul, Natalie E.
AU - DiGeronimo, Robert
AU - Keene, Sarah
AU - Hamrick, Shannon E.
AU - Mahmood, Burhan
AU - Rao, Rakesh
AU - Carr, Nicholas R.
N1 - Publisher Copyright:
© The Author(s) 2022.
PY - 2024/1
Y1 - 2024/1
N2 - Introduction: Comprehensive genetic testing with whole-exome (WES) or whole-genome (WGS) sequencing facilitates diagnosis, can optimize treatment, and may improve outcomes in critically ill neonates, including those requiring extracorporeal membrane oxygenation (ECMO) for respiratory failure. Our objective was to describe practice variation and barriers to the utilization of comprehensive genetic testing for neonates on ECMO. Methods: We performed a cross-sectional survey of Level IV neonatal intensive care units in the United States across the Children’s Hospitals Neonatal Consortium (CHNC). Results: Common indications for WES and WGS included concerning phenotype, severity of disease, unexpected postnatal clinical course, and inability to wean from ECMO support. Unexpected severity of disease on ECMO was the most common indication for rapid genetic testing. Cost of utilization was the primary barrier to testing. If rapid WES or WGS were readily available, 63% of centers would consider incorporating universal screening for neonates upon ECMO cannulation. Conclusion: Despite variation in the use of WES and WGS, universal testing may offer earlier diagnosis and influence the treatment course among neonates on ECMO. Cost is the primary barrier to utilization and most centers would consider incorporating universal screening on ECMO if readily available.
AB - Introduction: Comprehensive genetic testing with whole-exome (WES) or whole-genome (WGS) sequencing facilitates diagnosis, can optimize treatment, and may improve outcomes in critically ill neonates, including those requiring extracorporeal membrane oxygenation (ECMO) for respiratory failure. Our objective was to describe practice variation and barriers to the utilization of comprehensive genetic testing for neonates on ECMO. Methods: We performed a cross-sectional survey of Level IV neonatal intensive care units in the United States across the Children’s Hospitals Neonatal Consortium (CHNC). Results: Common indications for WES and WGS included concerning phenotype, severity of disease, unexpected postnatal clinical course, and inability to wean from ECMO support. Unexpected severity of disease on ECMO was the most common indication for rapid genetic testing. Cost of utilization was the primary barrier to testing. If rapid WES or WGS were readily available, 63% of centers would consider incorporating universal screening for neonates upon ECMO cannulation. Conclusion: Despite variation in the use of WES and WGS, universal testing may offer earlier diagnosis and influence the treatment course among neonates on ECMO. Cost is the primary barrier to utilization and most centers would consider incorporating universal screening on ECMO if readily available.
KW - exome sequencing
KW - extracorporeal membrane oxygenation
KW - genetic testing
KW - genome sequencing
UR - http://www.scopus.com/inward/record.url?scp=85139155539&partnerID=8YFLogxK
U2 - 10.1177/02676591221130178
DO - 10.1177/02676591221130178
M3 - Article
C2 - 36169593
AN - SCOPUS:85139155539
SN - 0267-6591
VL - 39
SP - 116
EP - 123
JO - Perfusion
JF - Perfusion
IS - 1
ER -