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Extracorporal membrane oxgenation(ECMO) in newborn infants:a systematic review

Andrews, W. (Department of Pediatrics, Memorial University of Newfoundland, Canada)
Simmons, B. (Department of Pediatrics, Memorial University of Newfoundland, Canada)
Aziz, K. (Department of Pediatrics, Memorial University of Newfoundland, Canada)
Friel, J. (Department of Biochemistry, Memorial University of Newfoundland, Canada)

Contact Person: w.l.andrews (wandrews@morgan.ucs.mun.ca)


ECMO is a technique of providing cardiopulmonary bypass to newborn infants with severe but potentially reversible pulmonary failure.While it has been in use for 20 years, there have persistent discussion on whether there was enough evidence to justify its widespread use. Even with the publication of a recent large randomized trial of ECMO from the UK,the is still commentry on the ethics of this trial (Paed. Perinatal Epidemiology July 1997). The purpose of abstract is to review systematically and cumulatively the effect of ECMO on infant deaths in the four published randomized trials.The studies are:Bartlett et al 1985 Pediatrics, O'Rourke et al 1989, Pediatrics, Gross et al 1994 Ped. Research and Uk Collaborative 1996, Lancet. The studies are of varying quality with small sample size, differing randomizaton methods and the difficulty of masking the intervention. Despite the differing quality, all four studies were included in the analysis. Only infants entering the study by randomization were included the analysis. With some studies having no deaths in the ECMO group,to aid in the calculations of relative risks, a correction factor of .5 was added to each cell in all studies. A logarithm of the RR method and a fixed effects model is used. This systematic review suggests that only with the completion of the large UK study was a high level of statistical signifcance obtained. The cumulative analysis suggest that statistical signifance was obtained after the third study, although this study was published only as a preliminary communication.

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Poster Number PAandrews0295
Keywords: ECMO, systematic, review, newborns

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Andrews, W.; Simmons, B.; Aziz, K.; Friel, J.; (1998). Extracorporal membrane oxgenation(ECMO) in newborn infants:a systematic review. Presented at INABIS '98 - 5th Internet World Congress on Biomedical Sciences at McMaster University, Canada, Dec 7-16th. Available at URL http://www.mcmaster.ca/inabis98/medicine/andrews0295/index.html
© 1998 Author(s) Hold Copyright