Prospective longitudinal evaluation of lung function during the first year of life after extracorporeal membrane oxygenation.
OBJECTIVE
To collect longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation and to evaluate relationships between lung function and perinatal factors. Longitudinal data on lung function in the first year of life after extracorporeal membrane oxygenation are lacking.


METHODS
Prospective longitudinal cohort study.


METHODS
Outpatient clinic of a tertiary level pediatric hospital.


METHODS
The cohort consisted of 64 infants; 33 received extracorporeal membrane oxygenation for meconium aspiration syndrome, 14 for congenital diaphragmatic hernia, four for sepsis, six for persistent pulmonary hypertension of the neonate, and seven for respiratory distress syndrome of infancy. Evaluation was at 6 mos and 12 mos; 39 infants were evaluated at both time points .


METHODS
None.


RESULTS
Functional residual capacity and forced expiratory flow at functional residual capacity were measured and expressed as z score. Mean (sem) functional residual capacities in z score were 0.0 (0.2) and 0.2 (0.2) at 6 mos and 12 mos, respectively. Mean (sem) forced expiratory flow was significantly below average (z score = 0) (p < .001) at 6 mos and 12 mos: -1.1 (0.1) and -1.2 (0.1), respectively. At 12 mos, infants with diaphragmatic hernia had a functional residual capacity significantly above normal: mean (sem) z score = 1.2 (0.5).


CONCLUSIONS
Infants treated with extracorporeal membrane oxygenation have normal lung volumes and stable forced expiratory flows within normal range, although below average, within the first year of life. There is reason to believe, therefore, that extracorporeal membrane oxygenation either ameliorates the harmful effects of mechanical ventilation or somehow preserves lung function in the very ill neonate.
Hofhuis
Ward
W
Department of Pediatrics, Division of Pediatric Respiratory Medicine, Erasmus Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.
Hanekamp
Manon N
MN
Ijsselstijn
Hanneke
H
Nieuwhof
Eveline M
EM
Hop
Wim C J
WC
Tibboel
Dick
D
de Jongste
Johan C
JC
Merkus
Peter J F M
PJ
D015199:Extracorporeal Membrane Oxygenation; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D015278:Intensive Care Units, Pediatric; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000503:physiopathology / Q000628:therapy; D055370:Lung Injury / Q000503:physiopathology / Q000628:therapy; D009426:Netherlands; D011446:Prospective Studies; D012129:Respiratory Function Tests