News | ECMO Systems | February 08, 2022

Researchers Identify Factors That May Help Predict Which Neonatal ECMO Patients Will Have to Return to the Hospital

Researchers analyzed the national Pediatric Health Information System database from 2005 to 2015 to see which neonatal ECMO patients were readmitted in the first 30 days after discharge and in the first year.

Extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment for critically ill neonates. But there has been little data published on which of these patients are more likely to be readmitted to the hospital later on.

February 8, 2022 —  Extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment for critically ill neonates. But there has been little data published on which of these patients are more likely to be readmitted to the hospital later on.

Recently, Children’s Hospital Los Angeles researchers shed new light on this area. A study, led by Ashwini Lakshmanan, MD, MS, MPH, Section Head of Epidemiology and Outcomes for the Fetal and Neonatal Institute, found that neonatal ECMO patients who also had cardiovascular or gastrointestinal conditions were at greater risk for readmission within the first year of their initial discharge. In particular, the team found that patients who had a gastrostomy (G-tube) had the highest risk for readmission. 

“While this was a retrospective study, the findings help highlight which ECMO patients are at increased risk and therefore could potentially benefit from additional educational support or care coordination,” said Lakshmanan, Director of the Laboratory for Fetal & Neonatal Healthcare Research at Children’s Hospital Los Angeles.

Researchers analyzed the national Pediatric Health Information System database from 2005 to 2015 to see which neonatal ECMO patients were readmitted in the first 30 days after discharge and in the first year. The data included 6,990 neonates who had received ECMO. Of those patients, 58% survived to discharge. Among survivors, readmissions were common—with 54% returning to the hospital within the first year.

Overall, 21% of patients were readmitted within the first 30 days. Among those with cardiovascular conditions, though, that number was twice as high, with 42% returning to the hospital within the first month.

“Babies who need ECMO today are an extremely high-risk population, much more so than 20 years ago,” said Rachel Chapman, MD, Associate Division Chief of Neonatology and Director of the Neonatal ECMO Program, who was a co-author on the study. “We have many therapies now that we use instead of ECMO. That means that the patients who end up needing ECMO are a much sicker and higher-risk group than in the past.”

Children’s Hospital Los Angeles has one of the largest neonatal ECMO programs in California. The Fetal and Neonatal Institute also has a robust health services research team, which includes Health Economist Cynthia Gong, PharmD, PhD, and Leah Yieh, MD, MPH, a neonatologist with expertise in cost-effectiveness analysis and resource utilization. Both were co-authors on the paper.

“The overarching goal of our research is to continually search for ways to enhance care for the complex babies we treat,” said Lakshmanan. “Part of that involves finding ways to determine which patients and families could potentially benefit the most from additional resources.”

Chapman added that optimizing care goes beyond an infant’s initial hospitalization. “We’re really thinking about the long journey in terms of preparing families for bumps in the road,” she says. “We want to give them the best tools and support possible to navigate those challenges and create the healthiest possible future for their baby.”

The study was published online last May in the Journal of Perinatology. The first author on the study was Ashley Song, now a postdoctoral fellow at Johns Hopkins University. Additional co-authors were Michael Fenlon, MD; and Lorraine Kelley-Quon, MD, and Philippe Friedlich, MD, MSEpi, MBA, from Children’s Hospital Los Angeles.

For more information: https://www.chla.org/

Find more ECMO content


Related Content

News | Pediatric Cardiology

November 25, 2022 — Jodie Votava-Smith, MD, has pulled up two side-by-side echocardiograms on her computer screen and is ...

Home November 25, 2022
Home
News | Pediatric Cardiology

November 23, 2022 — Cardiopulmonary exercise testing (CPET) can detect underlying early signs of cardiovascular problems ...

Home November 23, 2022
Home
News | Pediatric Cardiology

November 14, 2022 — For more than four decades, doctors have been split on whether giving steroids during a pediatric ...

Home November 14, 2022
Home
News | Pediatric Cardiology

October 27, 2022 — Elite young athletes are set to benefit from a novel screening tool with the potential to change ...

Home October 27, 2022
Home
News | Pediatric Cardiology

September 28, 2022 — Babies born with heart valve defects will have as many as 3 to 5 open heart surgeries before ...

Home September 28, 2022
Home
News | Pediatric Cardiology

September 20, 2022 — Medtronic, a global leader in healthcare technology, today announced the LINQ II Insertable Cardiac ...

Home September 20, 2022
Home
News | Pediatric Cardiology

July 13, 2022 — Black children who underwent heart transplant surgery for the first time were more than three times as ...

Home July 13, 2022
Home
News | Pediatric Cardiology

July 1, 2022 — Most children and adolescents living in the U.S. have suboptimal scores for cardiovascular health (CVH) ...

Home July 01, 2022
Home
News | Pediatric Cardiology
April 18, 2022 – Deepening its commitment to pediatric cardiovascular research, the Children's Hospital of Philadelphia ...
Home April 18, 2022
Home
News | Pediatric Cardiology
March 2, 2022 – As 1-year-old SaRyia Moore and her family celebrate American Heart Month, they do so will full, grateful ...
Home March 02, 2022
Home
Subscribe Now