Respiratory function in survivors of the United Kingdom extracorporeal membrane oxygenation trial

Extracorporeal membrane oxygenation (ECMO) improves survival in mature neon ates with reversible lung disease. However, ECMO could result in survival o f infants with severe respiratory dysfunction who would otherwise have died . Alternatively, infants receiving ECMO might be spared prolonged ventilati on and consequent barotrauma, resulting in improved respiratory function. O ur aim was to compare respiratory function at 1 yr of age in infants assign ed to receive either ECMO or conventional management (CM). Seventy-eight su rviving infants of the United Kingdom (UK) ECMO trial (51 in the ECMO group ) were studied at 1 yr of age. Questionnaires provided details of respirato ry symptoms, and laboratory measurements of respiratory function were made for respiratory rate, tidal volume, lung volume, airway conductance, specif ic airway conductance, and maximal expiratory flow at FRC (V) over dot max( FRC)). Data were exchanged on floppy disk for cross-analysis and to ensure that investigators were blinded to the status of the infants. There was a w ide spectrum of respiratory function, from normal to markedly abnormal. The re were few differences between the groups, but in the CM group lung volume was increased (95% confidence intervals [CIs] of the difference in ECMO ve rsus CM subjects: -67; -4 ml), and inspiratory specific conductance was low er (95% CI: 0.03; 0.98 s(-1) kPa(-1)). There was a trend toward a lower (V) over dot max(FRC) (95% CI: -2; 67 ml/s(-1) in the CM group. In addition to providing a survival advantage, ECMO did not worsen lung function in infan ts assigned to receive it. Indeed, their lung function appeared slightly be tter than that of infants treated conventionally.