Extracorporeal Membrane Oxygenation (ECMO) Risk Stratification in Newborns with Congenital Diaphragmatic Hernia (CDH)

Space: StayCurrentMD Author: Tim Jancelewicz, Mary E. Brindle, Matthew T. Harting, Elizabeth A. Tolley, Max R. Langham, Pamela A. Lally, Ankush Gosain, Stephanie A. Storgion, David W. Kays, Congenital Diaphragmatic Hernia Study Group Published:

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Tim Jancelewicz, Mary E. Brindle, Matthew T. Harting, Elizabeth A. Tolley, Max R. Langham, Pamela A. Lally, Ankush Gosain, Stephanie A. Storgion, David W. Kays, Congenital Diaphragmatic Hernia Study Group

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Abstract

Background

A means for early postnatal stratification of ECMO risk in CDH newborns could be used to comparatively assess the utilization and outcomes of ECMO use between centers. While multiple CDH mortality risk calculators are available, no validated tool exists specifically for prediction of ECMO use. The purpose of this study was to derive and validate an ECMO risk stratification model.

Methods

The study population was obtained from CDH Study Group registry for the period between 2007 and 2016. Only centers offering ECMO were included. The cohort was restricted to ECMO candidates and then divided into derivation and validation sets. Using all relevant perinatal predictors in the registry, univariate analysis was performed for the composite outcome of ECMO use or death without ECMO use. The model was derived using the derivation cohort with multivariable logistic regression and automatic stepwise forward selection (P 

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