An overview of medical ECMO for neonates

Kathryn Fletcher; Rachel Chapman; Sarah Keene

doi:10.1053/j.semperi.2017.12.002

An overview of medical ECMO for neonates

Semin Perinatol. 2018 Mar;42(2):68-79. doi: 10.1053/j.semperi.2017.12.002. Epub 2018 Jan 12.

Authors

Kathryn Fletcher¹, Rachel Chapman², Sarah Keene³

Affiliations

¹ Department of Pediatrics, Division of Neonatology, LAC + USC Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, CA; Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
² Department of Pediatrics, Division of Neonatology, LAC + USC Medical Center, Keck School of Medicine of University of Southern California, Los Angeles, CA; Division of Neonatology, Fetal and Neonatal Institute, Children's Hospital Los Angeles, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA. Electronic address: Rachapman@chla.usc.edu.
³ Division of Neonatal-Perinatal Medicine, Emory University School of Medicine, Atlanta, GA; Children's Healthcare of Atlanta, Atlanta, GA.

PMID: 29336834
DOI: 10.1053/j.semperi.2017.12.002

Abstract

Extracorporeal membrane oxygenation (ECMO), a life-saving therapy for respiratory and cardiac failure, was first used in neonates in the 1970s. The indications and criteria for ECMO have changed over the years, but it continues to be an important option for those who have failed other medical therapies. Since the Extracorporeal Life Support Organization (ELSO) Registry was established in 1989, more than 29,900 neonates have been placed on ECMO for respiratory failure, with 84% surviving their ECMO course, and 73% surviving to discharge or transfer. In this chapter, we will review the basics of ECMO, patient characteristics and criteria, patient management, ECMO complications, special uses of neonatal ECMO, and patient outcomes.

Keywords: Extracorporeal membrane oxygenation; Medical ECMO; Neonatal ECMO; Neonatal respiratory failure; Persistent pulmonary hypertension.

Publication types

Review

MeSH terms

Evidence-Based Medicine
Extracorporeal Membrane Oxygenation* / methods
Extracorporeal Membrane Oxygenation* / mortality
Hernia, Diaphragmatic / mortality
Hernia, Diaphragmatic / therapy*
Humans
Infant, Newborn
Meconium Aspiration Syndrome / mortality
Meconium Aspiration Syndrome / therapy*
Practice Guidelines as Topic
Randomized Controlled Trials as Topic
Respiratory Distress Syndrome, Newborn / mortality
Respiratory Distress Syndrome, Newborn / therapy*
Sepsis / mortality
Sepsis / therapy*
Survival Rate