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National trends in neonatal extracorporeal membrane oxygenation in the United States

Journal of Perinatology volume 38, pages 1106–1113 (2018)Cite this article

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Abstract

Objective

To determine trends in neonatal extracorporeal membrane oxygenation (ECMO) utilization from 2002–2011.

Study design

Using the Nationwide inpatient sample (NIS), we conducted a population-based retrospective cohort study to identify ECMO utilization among neonates. Incidence of ECMO utilization, length of stay (LOS), cost and mortality were estimated.

Result

In all, 33,367,146 neonates were identified of which 7603 (18 per 100,000 live births) underwent ECMO. Neonatal ECMO increased from 12 to 23 runs per 100,000 live births. Mortality was 48.4%, decreasing from 47.5 to 41.9% between 2002 and 2011. On multivariate analysis, mortality was significantly higher for infectious indications (OR 4.1; CI 1.1–16.0), E-CPR (OR 3.8; CI 1.4–10.7) and cardiac indications (OR 2.0; CI 1.5–2.8). On hierarchical regression, LOS increased by 1.6 days each year (p = 0.02) and cost of hospitalization increased by $14,033 each year (p < 0.0001).

Conclusion

Neonatal ECMO utilization increased, while mortality decreased during the study period. These findings suggest an improvement in neonatal ECMO care.

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Acknowledgements

We acknowledge the Healthcare Cost and Utilization Project (HCUP) sponsored by the Agency for Healthcare Research and Quality, Rockville, MD and its partner organizations that provide data to the HCUP. A list of all HCUP data partners is available at https://www.hcup-us.ahrq.gov/db/hcupdatapartners.jsp

Author information

Authors and Affiliations

  1. Texas Tech University Health Sciences Center, Amarillo, TX, USA

    Parth Bhatt & Sumesh Parat

  2. Mercy Health West Hospital, Cincinnati, OH, USA

    Anusha Lekshminarayanan

  3. University of Miami, Miami, FL, USA

    Keyur Donda & Fredrick Dapaah-Siakwan

  4. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Achint Patel

  5. University of Washington, Seattle, WA, USA

    Zeenia Billimoria

Authors
  1. Parth Bhatt
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  2. Anusha Lekshminarayanan
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Correspondence to Zeenia Billimoria.

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The authors declare that they have no conflict of interest.

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Bhatt, P., Lekshminarayanan, A., Donda, K. et al. National trends in neonatal extracorporeal membrane oxygenation in the United States. J Perinatol 38, 1106–1113 (2018). https://doi.org/10.1038/s41372-018-0129-4

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