Background and aim: Pulmonary hypertension (PH) is the most important determiner of mortality in neonates with congenital diaphragmatic hernia (CDH). PH can be assessed by echocardiography but knowledge on potential biomarkers is scarce. Soluble ST2 (sST2) is released by cardiomyocytes experiencing increased workload and has been extensively investigated in the adult population. Aim of our study was to investigate the expression of sST2 in CDH newborns receiving ECMO support compared to patients without ECMO.

Methods: 30 CDH newborns were prospectively enrolled. sST2 concentration was measured from EDTA-Plasma at the age of 0, 6, 12, 24, 48 hours and 7-10 days of life and was compared in CDH newborns with and without ECMO support. 

Results: 11/30 patients were allocated to the ECMO group and 19/30 to the non-ECMO group. Patients in the ECMO group were affected more severely (lung-to-head ratio and liver-up). At birth sST2 were similar between groups (p=0.668). At 6, 12, 24, 48 hours and at 7-10 days sST2 concentration was significantly higher in the ECMO group (Table 1). At 6 hours the optimal cutoff to predict ECMO was 48.0 ng/ml (AUC 0.742; p = 0.035) with a sensitivity of 80%, and a specificity of 78.9% (Positive predictive value: 66.7%, Negative predictive value: 88.2%). sST2 correlated significantly with PH severity at 6h (r=0.597, p=0.001), 12h (r=0.616, p<0.001) and 24h (r=0.720, p<0.001).

Conclusion: sST2 expression differed significantly in CDH newborns according to disease severity and might be a potential parameter to assess risk for ECMO in this population.

0084 - INCREASED SOLUBLE ST2 CONCENTRATION IN NEONATES WITH CONGENITAL DIAPHRAGMATIC AND PULMONARY HYPERTENSION RECEIVING ECMO SUPPORT.