Intracranial hemorrhage in premature neonates treated with extracorporeal membrane oxygenation correlates with conceptional age.
OBJECTIVE
To determine the effect of patient age on the risk of intracranial hemorrhage (ICH) in premature neonates treated with extracorporeal membrane oxygenation (ECMO).


METHODS
This was a retrospective cohort study of neonates of <37 weeks' gestation treated with ECMO in the years 1992 through 2000 and reported to the Extracorporeal Life Support Organization Registry (n=1524). The relation between ICH and patient age, defined as gestational age, postnatal age (PNA), and postconceptional age (PCA), was determined with the use of multiple logistic regression analysis.


RESULTS
PNA was inversely correlated with ICH in the univariate analysis (P=.01) but not in the multivariate analysis (P=.36). PCA showed a strong univariate correlation with decreasing ICH: 26% of patients </=32 weeks' PCA developed ICH as compared with 6% of patients with PCA of 38 weeks (P=.004). Multiple logistic regression identified as independent predictors of ICH: PCA (P=.005), sepsis (P=.004), acidosis (P=.0004), and treatment with sodium bicarbonate (P=.002). Gestational age was correlated with ICH in the multivariate model only when PNA was included.


CONCLUSIONS
Postnatal age is not a strong independent predictor of ICH in premature neonates treated with ECMO. PCA is the best age-related predictor of ECMO-related ICH in premature infants.
Division of Pediatric Critical Care, Department of Pediatrics, Morgan Stanley Children's Hospital of New York, New York 10032-3784, USA. gh2115@columbia.edu
George E
GE
Hardart
M Kathleen M
MK
Hardart
John H
JH
Arnold
D000367:Age Factors; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000209:etiology*; D020300:Intracranial Hemorrhages / Q000209:etiology*; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D012307:Risk Factors