86 PROSPECTIVE RANDOMIZED CONTROLLED TRIAL OF CONVENTIONAL TREATMENT OR TRANSPORT FOR ECMO IN INFANTS WITH SEVERE PERSISTENT PULMONARY HYPERTENSION (PPHN): TWO YEAR FOLLOW UP

Abstract

28 of 31 ECMO eligible infants born July, 1988 to March, 1992 with severe PPHN were assigned randomly when oxygenation index (OI) was ≥ 40 for four hours to be transported for ECMO (n=15, birthweight 3601 ± 622 g; OI 63 ± 28) or to receive conventional therapy at our center (n=13, birthweight 3403 ± 640 g; OI 60 ± 28). Fourteen of the 15 infants (93%) transported for ECMO survived to hospital discharge (including 3 who did not receive ECMO), while 7 of 13 (54%) conventionally treated infants survived (p<05). One ECMO infant died after hospital discharge at age 3 months of SIDS. Outcome for the survivors (mean ± SD): ECMO salvaged sicker neonates (mean OI at study entry for ECMO survivors was 60 ± 21 vs 44 ± 5 for conventionally treated survivors); nevertheless, transport for ECMO was not associated with worse neurodevelopmental outcome at 2 years. These data support the use of ECMO in term infants with severe respiratory distress.