Fellow Baylor College of Medicine Houston, Texas, United States
Background: Neonates requiring extracorporeal membrane oxygenation (ECMO) constitute a nutritionally vulnerable group of patients. During ECMO, supporting end organ perfusion while limiting fluid overload capillary leak by restricting fluid intake may take precedence over nutritional needs. Incorporating slow continuous ultrafiltration (SCUF) techniques offers a promising approach to enhance nutrition. Despite the widespread adoption of SCUF, its impact on nutritional provision remains undetermined. Objective: The primary objective is to compare total calorie and protein delivery to neonates receiving SCUF with those who did not receive SCUF while on ECMO, using the ASPEN (American Society for Parenteral and Enteral Nutrition) guidelines as a benchmark. Design/Methods: After institutional review board (IRB) approval, we conducted a retrospective chart review of neonates undergoing ECMO at Texas Children’s Hospital neonatal intensive care unit. We collected demographics and nutritional data on neonates with gestational ages ≥ 34 weeks and ≥ 2 kg. Neonates with life-limiting genetic syndromes and critical congenital heart diseases were excluded. Neonates were categorized as the SCUF group or exposed group (2014- 2022), and the group not exposed to SCUF or control group (2010- 2014). Neonates were stratified by indication for ECMO: meconium aspiration, congenital diaphragmatic hernia, infection, and persistent pulmonary hypertension secondary to other causes. We will compare demographics and clinical characteristics between the two groups. We have obtained the data and are working on the next steps of organizing and completing the data analysis. We estimate to complete the analysis by January 1, 2024. Nutritional outcomes and quantitative covariates will be compared in the SCUF exposed vs. unexposed cohorts using the Wilcoxon rank sum test, while categorical covariates will be compared using Fisher’s exact test. Multiple linear regression will be used to compare nutritional outcomes after controlling for any covariates found to be significantly imbalanced between the two cohorts.
