Increased carotid artery intima-media thickness following venoarterial extracorporeal membrane oxygenation in the neonatal period.
OBJECTIVE
To compare left carotid intima-media thickness (CIMT) and biochemical markers for atherogenesis in neonatal venoarterial extracorporeal membrane oxygenation (ECMO) survivors with normal controls during childhood.


METHODS
Venoarterial ECMO survivors and healthy patients between 12 and 18 years of age were enrolled in a matched control prospective study. ECMO survivors were matched to controls based on chronological age and percentage of body mass index (BMI). Measured CIMT of the posterior left carotid artery and CIMT values corrected for carotid artery size were used for data analysis.


RESULTS
Thirty-one neonatal venoarterial ECMO survivors were matched to 31 healthy controls. No significant differences were found between ECMO survivors and controls for age, weight, percentage of BMI, total fat composition, lipid profiles, ultrasensitive C-reactive protein or homocysteine levels. Significant differences between ECMO and controls patients were found in systolic, diastolic and mean left CIMT.


CONCLUSIONS
Compared with controls, the thickness of the left carotid intima media is significantly increased at the age of 12 to 18 years in neonatal venoarterial ECMO survivors. The clinical significance of this increased CIMT is unknown. ECMO centers may want to incorporate assessment of CIMT in their follow-up protocols.
Friedlich
P
P
Division of Newborn and Infant Critical Care, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Childrens Hospital Los Angeles, Keck School of Medicine, University of Southern California, CA 90027, USA. pfriedlich@chla.usc.edu
Gonzalez
J
J
Nield
T
T
Keshava
H
H
Stein
J
J
Seri
I
I
Gilsanz
V
V
D000293:Adolescent; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D055815:Young Adult