To compare the resource implications and short term outcomes of extracorporeal membrane oxygenation and conventional management for term babies with severe respiratory failure.
Cost effectiveness evaluation alongside a randomised controlled trial.
55 approved recruiting hospitals in the United Kingdom.
These hospitals provided conventional management, but infants randomised to extracorporeal membrane oxygenation were transferred to one of five specialist centres.
185 mature newborn infants (gestational age at birth>35 weeks, birth weight>2 kg) with severe respiratory failure (oxygenation index>40) recruited between 1993 and 1995.
The commonest diagnoses were persistent pulmonary hypertension due to meconium aspiration, congenital diaphragmatic hernia, isolated persistent fetal circulation, sepsis, and idiopathic respiratory distress syndrome.
Cost effectiveness based on survival at 1 year of age without severe disability.
63 (68%) of the 93 infants randomised to extracorporeal membrane oxygenation survived to 1 year compared with 38 (41%) of the 92 infants who received conventional management.
Of those that survived, one infant in each arm was lost to follow up and the proportion with disability at I year was similar in the two arms of the trial.
One child in each arm had severe disability. (...)
Mots-clés Pascal : Insuffisance respiratoire, Aigu, Nouveau né, Homme, Oxygénateur membrane, Circuit extracorporel, Randomisation, Analyse coût efficacité, Etude comparative, Essai clinique, Royaume Uni, Europe, Appareil respiratoire pathologie, Réanimation, Traitement instrumental, Economie santé
Mots-clés Pascal anglais : Respiratory failure, Acute, Newborn, Human, Membrane oxygenator, Extracorporeal circuit, Randomization, Cost efficiency analysis, Comparative study, Clinical trial, United Kingdom, Europe, Respiratory disease, Resuscitation, Instrumentation therapy, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0470001
Code Inist : 002B27B11. Création : 19/02/1999.