First 24-h SNAP-II score and highest PaCO2 predict the need for ECMO in congenital diaphragmatic hernia

Alana J. Coleman, Beverly Brozanski, Burhan Mahmood, Peter D. Wearden, Douglas Potoka, Bradley A. Kuch

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background/Purpose Early clinical predictors for the use of ECMO in patients with congenital diaphragmatic hernia (CDH) are lacking. We sought to evaluate the first 24-h SNAP-II score and highest PaCO2 as predictors of ECMO support and in-hospital mortality in neonates with CDH. Methods Retrospective review of 47 consecutive neonates with CDH admitted to our institution from January 2007 to December 2010 was performed. Covariates of ECMO use including SNAP-II score and highest PaCO2 within the first 24 h of NICU admission were evaluated. Results Of the 47 infants in this study, 24 patients were supported with ECMO. The ECMO group had a higher incidence of pulmonary hypertension, higher PaCO2, and higher 24-h SNAP-II scores. Only the SNAP-II score and not highest PaCO2 predicted mortality following multivariate adjustment. Conclusions The first 24-h SNAP-II score and highest PaCO2 may provide some prognostic value in identifying neonates who undergo ECMO support; however neither measure was independently associated with the use of therapy. Only the SNAP-II score was associated with in-hospital mortality following multivariate adjustment. Additional study is needed to validate these results in a larger data set.

Original languageEnglish
Pages (from-to)2214-2218
Number of pages5
JournalJournal of Pediatric Surgery
Volume48
Issue number11
DOIs
StatePublished - Nov 1 2013

Keywords

  • Congenital diaphragmatic
  • Extracorporeal membrane
  • SNAP-II score
  • hernia
  • oxygenation

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