Effect of pump type on outcomes in neonates with congenital diaphragmatic hernia requiring ECMO

Purpose: With the exception of neonatal respiratory failure, most centers are now using centrifugal over roller-type pumps for the delivery of extracorporeal membrane oxygenation (ECMO). Evidence supporting the use of centrifugal pumps specifically in infants with congenital diaphragmatic hernia (CD...

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Bibliographic Details
Published in:Perfusion 2018-05, Vol.33 (1_suppl), p.71-79
Main Authors: Delaplain, Patrick T., Zhang, Lishi, Nguyen, Danh V., Ashrafi, Amir H., Yu, Peter T., Di Nardo, Matteo, Chen, Yanjun, Starr, Joanne, Ford, Henri R., Guner, Yigit S.
Format: Article
Language:English
Subjects:
Centrifugal pumps
Erythrocytes
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - adverse effects
Extracorporeal Membrane Oxygenation - methods
Female
Hemolysis
Hernia
Hernias
Hernias, Diaphragmatic, Congenital - pathology
Hernias, Diaphragmatic, Congenital - therapy
Humans
Identification methods
Infant, Newborn
Infants
Male
Mortality
Neonates
Newborn babies
Oxygenation
Patients
Pumps
Respiratory failure
Respiratory therapy
Treatment Outcome
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Summary:Purpose: With the exception of neonatal respiratory failure, most centers are now using centrifugal over roller-type pumps for the delivery of extracorporeal membrane oxygenation (ECMO). Evidence supporting the use of centrifugal pumps specifically in infants with congenital diaphragmatic hernia (CDH) remains lacking. We hypothesized that the use of centrifugal pumps in infants with CDH would not affect mortality or rates of severe neurologic injury (SNI). Methods: Infants with CDH were identified within the ELSO registry (2000-2016). Patients were then divided into those undergoing ECMO with rollertype pumps or centrifugal pumps. Patients were matched based on propensity score (PS) for the ECMO pump type based on pre-ECMO covariates. This was done for all infants and separately for each ECMO mode, venovenous (VV) and venoarterial (VA) ECMO. Results: We identified 4,367 infants who were treated with either roller or centrifugal pumps from 2000-2016. There was no difference in mortality or SNI between the two pump types in any of the groups (all infants, VA-ECMO infants, VV-ECMO infants). However, there was at least a six-fold increase in the odds of hemolysis for centrifugal pumps in all groups: all infants (odds ratio [OR] 6.99, p
ISSN:0267-6591
1477-111X
DOI:10.1177/0267659118766729