Subscribe to RSS
DOI: 10.1055/s-2000-13449
ECMO IN THE NEWBORN
Publication History
Publication Date:
31 December 2000 (online)
![](https://www.thieme-connect.de/media/ajp/200007/lookinside/thumbnails/10.1055-s-2000-13449-1.jpg)
ABSTRACT
Since the first use in neonates in 1974, extracorporeal membrane oxygenation (ECMO) has been a life-saving technology for newborns with respiratory and cardiac failure. ECMO has been used to treat a variety of cardio-respiratory problems, including meconium aspiration syndrome (MAS), persistent pulmonary hypertension of the neonate (PPHN), congenital diaphragmatic hernia (CDH), sepsis, and cardiac anomalies. For this group of high-mortality neonates, ECMO has produced a survival of 76% in all newborns treated. This review article will examine the current selection criteria for ECMO, the clinical management of neonates on ECMO and discuss the long-term outcome of neonates treated with ECMO.
KEYWORD
Extracorporeal membrane oxygenation (ECMO) - neonate - respiratory failure
REFERENCES
-
1 Extracorporeal Life Support Organization. ECLS Registry Report: International Summary. July, 1999
- 2 Cilley R E, Zwischenberger J B, Andrews A F, Bowerman R A, Roloff D W, Bartlett R H. Intracranial hemorrhage during extracorporeal membrane oxygenation in neonates. Pediatrics . 1986; 78 699-704
- 3 Sell L L, Cullen M L, Whittlesey G C. Hemorrhagic complications during extracorporeal membrane oxygenation: Prevention and treatment. J Pediatr Surg . 1986; 21 1087-1091
- 4 Allmen D, Babcock D, Matsumoto J. The predictive value of head ultrasound in the ECMO candidate. J Pediatr Surg . 1992; 27 36-39
- 5 Northway W H, Rosan R C, Porter D Y. Pulmonary disease following respiratory therapy of hyaline-membrane disease. N Engl J Med . 1967; 276 357-368
- 6 Kornhauser M S, Cullen J A, Baumgart S, McKee L J, Gross G W, Spitzer A R. Risk factors for bronchopulmonary dysplasia after extracorporeal membrane oxygenation. Arch Ped Adolesc Med . 1994; 148 820-825
- 7 Sanders R J, Cox C, Phelps D L, Sinkin R A. Two doses of early intravenous dexamethasone for the prevention of bronchopulmonary dysplasia in babies with respiratory distress syndrome. Pediatr Res . 1994; 36 122-128
- 8 Wung J T, James L S, Kilchevsky E, James E. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics . 1985; 76 488-494
- 9 Krummel T M, Greenfield L J, Kirkpatrick B V. Alveolar-arterial oxygen gradients versus the neonatal pulmonary insufficiency index for prediction of mortality in ECMO candidates. J Pediatr Surg . 1984; 19 380-384
- 10 Beck R, Anderson K D, Pearson G D, Cronin J, Miller M K, Short B L. Criteria for extracorporeal membrane oxygenation in a population of infants with persistent pulmonary hypertension of the newborn. J Pediatr Surg . 1986; 21 297-302
- 11 Marsh T D, Wilkerson S A, Cook L N. Extracorporeal membrane oxygenation selection criteria: partial pressure of arterial oxygen versus alveolar-arterial oxygen gradient. Pediatrics . 1988; 82 162-166
- 12 Ortiz R M, Cilley R E, Bartlett R H. Extracorporeal membrane oxygenation in pediatric respiratory failure. Pediatr Clin North Am . 1987; 34 39-46
- 13 Keszler M, Subramanian K N, Smith Y A. Pulmonary management during extracorporeal membrane oxygenation. Crit Care Med . 1989; 17 495-500
- 14 Raithel S C, Pennington D G, Boegner E, Fiore A, Weber T R. Extracorporeal membrane oxygenation in children after cardiac surgery. Circulation . 1992; 86 22305-22310
- 15 Sakai H, Tamura M, Hosokawa Y, Bryan A C, Barker G A, Bohn D J. Effect of surgical repair on respiratory mechanics in congenital diaphragmatic hernia. J Pediatr . 1987; 111 432-438
- 16 Cartlidge P HT, Mann N P, Kapila L. Preoperative stabilization in congenital diaphragmatic hernia. Arch Dis Child . 1986; 61 1226-1228
- 17 Breaux Jr W C, Rouse T M, Cain W S, Georgeson K E. Improvement in survival of patients with congenital diaphragmatic hernia utilizing a strategy of delayed repair after medical and/or extracorporeal membrane oxygenation stabilization. J Pediatr Surg . 1991; 26 333-338
- 18 West K W, Bengston K, Rescorla F J, Engel W A, Grosfeld J L. Delayed surgical repair and ECMO improves survival in congenital diaphragmatic hernia. Ann Surg . 1992; 216 454-462
- 19 Nakayama D K, Motoyama E K, Tagge E M. Effect of preoperative stabilization on respiratory system compliance and outcome in newborn infants with congenital diaphragmatic hernia. J Pediatr . 1991; 118 793-799
- 20 Wung J T, Sahni R, Moffitt S T, Lipsitz E, Stolar C J. Congenital diaphragmatic hernia: survival treated with very delayed surgery, spontaneous respiration, and no chest tube. J Pediatr Surg . 1995; 30 406-409
- 21 Lally K P, Paranka M S, Roden J. Congenital diaphragmatic hernia: stabilization and repair on ECMO. Ann Surg . 1992; 216 569-573
- 22 Stewart D, Mendoza J, Winston S, Cook L. Extracorporeal life support (ECLS) in infants with total anomalous pulmonary venous drainage (TAPVD): a review of the ELSO registry. CNMC ECMO Symposium 81, 1992
- 23 Revenis M, Glass P, Short B L. Mortality and morbidity rates among lower birth weight infants (2000 to 2500 grams) treated with extracorporeal membrane oxygenation. J Pediatr . 1992; 121 452-458
- 24 Grimm P. Feeding difficulties in infants treated with ECMO. CNMC ECMO Symposium 25, 1993
- 25 Nield T, Hallaway M, Fodera C. Outcome in problem feeders post ECMO. CNMC ECMO Symposium 79, 1990
- 26 Glass P. Patient neurodevelopmental outcomes after neonatal ECMO. In: Arensman R, Cornish J, eds. Extracorporeal Life Support Boston: Blackwell Scientific Publications 1993: 241-251
- 27 Tarby T, Waggoner J. Are the common neurologic problems following ECMO related to jugular bulb thrombosis?. CNMC ECMO Symposium 110, 1994
- 28 Van Meurs K, Robbins S, Reed V, Glass P, O'Brien A, Short B L. Congenital diaphragmatic hernia: long-term outcome of neonates treated with ECMO. CNMC ECMO Symposium 25, 1991
- 29 Rajasingham S, Reed V, Glass P. Congenital diaphragmatic hernia: outcome post-ECMO at 5 years. CNMC ECMO Symposium 35, 1994
- 30 Glass P, Wagner A, Papero P. Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation. J Pediatr . 1995; 127 447-457
- 31 Walsh-Sukys M, Bauer R, Cornell D, Friedman H, Stork E, Hack M. Severe respiratory failure in neonates: mortality and morbidity rates and neurodevelopmental outcomes. J Pediatr . 1994; 125 104-110
- 32 Gershan L, Gershan W, Day S. Airway anomalies after ECMO: bronchoscopic findings. CNMC ECMO Symposium 65, 1992
- 33 Wagner A, Glass P, Papero P, Coffman C, Kjaer M, Short B L. Neuropsychological outcome of neonatal ECMO survivors at age 5. CNMC ECMO Symposium 31, 1994
- 34 D'Agostino J, Bernbaum J, Gerdes M. Outcome for infants with congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation: the first year. J Pediatr Surg . 1995; 30 10-15
- 35 Van Meurs K, Robbins S, Reed V. Congenital diaphragmatic hernia: long-term outcome in neonates treated with extracorporeal membrane oxygenation. J Pediatr . 1993; 122 893-899
- 36 Atkinson J, Poon M. ECMO and the management of congenital diaphragmatic hernia with large diaphragmatic defects requiring a prosthetic patch. J Pediatr Surg . 1992; 27 754-756
- 37 Adolph V, Ekelund C, Smith C, Starrett A, Falterman K, Arensman R. Developmental outcome of neonates treated with ECMO. J Pediatr Surg . 1990; 25 43-46
- 38 Andrews A, Nixon C, Cilley R, Roloff D, Bartlett R. One-to-three year outcome for 14 neonatal survivors of extracorporeal membrane oxygenation. Pediatrics . 1986; 78 692-698
- 39 Flusser H, Dodge N, Engle W, Garg B, West K. Neurodevelopmental outcome and respiratory morbidity for ECMO survivors at 1 year of age. J Perinatol . 1993; 13 266-271
- 40 Glass P, Miller M, Short B L. Morbidity for survivors of extracorporeal membrane oxygenation: neurodevelopmental outcome at 12 years of age. Pediatrics . 1989; 83 72-78
- 41 Griffin M, Minifee P, Landry S, Allison P, Swischuk L, Zwischenberger J. Neurodevelopmental outcome in neonates after ECMO: cranial magnetic resonance imaging and ultrasonography correlation. J Pediatr Surg . 1992; 27 33-35
- 42 Hofkosh D, Thompson A, Nozza R, Kemp S, Bowen A, Feldman H. Ten years of ECMO: neurodevelopmental outcome. Pediatrics . 1991; 87 549-555
- 43 Krummel T, Greenfield L, Kirkpatrick B. The early evaluation of survivors after ECMO for neonatal pulmonary failure. J Pediatr Surg . 1984; 19 585-590
- 44 Schumacher R, Palmer T, Roloff D, LaClaire P, Bartlett R. Follow-up of infants treated with ECMO for newborn respiratory failure. Pediatrics . 1991; 87 451-457
- 45 Towne B, Lott I, Hicks D, Healey T. Long-term follow-up of infants and children treated with ECMO: a preliminary report. J Pediatr Surg . 1985; 20 410-414
- 46 Wildin S, Landry S, Zwischenberger J. Prospective, controlled study of developmental outcome in survivors of ECMO: the first 24 months. Pediatrics . 1994; 93 404-408
- 47 Stolar C J, Crisafi M A, Driscoll Y T. Neurocognitive outcome for neonates treated with extracorporeal membrane oxygenation: are infants with congenital diaphragmatic hernia different?. J Pediatr Surg . 1995; 30 366-372
- 48 Davis D, Wilkerson S, Stewart D. Neurodevelopmental follow-up of ECMO survivors at 7 years. CNMC ECMO Symposium 34, 1995
- 49 Stanley C, Brodsky K, McKee L, Gringlas M, Graziani L. Developmental profile of ECMO survivors at early school age and relationship to neonatal EEG status. CNMC ECMO Symposium 33, 1995
- 50 Hack M, Taylor H, Klein N, Eiben R, Schatschneider C, Mercuri-Minich N. School-age outcomes in children with birthweights under 750 g. N Engl J Med . 1994; 331 753-759
- 51 Walton J, Hendricks-Munoz K. Profile and stability of sensorineural hearing loss in persistent pulmonary hypertension of the newborn. J Speech Hear Res . 1991; 34 1362-1370
- 52 Naulty C, Weiss I, Herer G. Progressive sensorineural hearing loss in survivors of persistent fetal circulation. Ear Hear . 1986; 7 74-77
- 53 Leavitt A, Watchko J, Bennett F, Folson R. Neurodevelopmental outcome following persistent pulmonary hypertension of the neonate. J Perinatol . 1987; 7 88-291
- 54 Sell E, Gaines J, Gluckman C, Williams E. Persistent fetal circulation: neurodevelopmental outcome. Am J Dis Child . 1985; 139 25-28
- 55 Marron M, Crisafi M, Driscoll J. Hearing and neurodevelopmental outcome in survivors of persistent pulmonary hypertension of the newborn. Pediatrics . 1992; 90 392-396
- 56 Bifano E, Pfannenstiel A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics . 1988; 81 657-661
- 57 Ferrara B, Johnson D, Chang P, Thompson T. Efficacy and neurologic outcome of profound hypocapneic alkalosis for the treatment of persistent pulmonary hypertension in infancy. Pediatrics . 1984; 105 457-461
- 58 Bernbaum J, Russell P, Sheridan P, Gewitz M, Fox W, Peckham G. Long-term follow-up of newborns with persistent pulmonary hypertension. Crit Care Med . 1984; 12 579-583
- 59 Desai S, Stanley C, Graziani L, McKee L, Baumgart S. Brainstem auditory evoked potential screening (BAEP) unreliable for detecting sensorineural hearing loss in ECMO survivors: a comparison of neonatal BAEP and follow-up behavioral audiometry. CNMC ECMO Symposium 62, 1994
- 60 Haney B, Thibeault D, Sward-Comunelli S, Grin T, Stass-Isern M, Grist G. Ocular findings in infants treated with ECMO. CNMC ECMO Symposium 63, 1994
- 61 Hahn J, Vaucher Y, Bejar R, Coen R. Electroencephalographic and neuroimaging findings in neonates undergoing extracorporeal membrane oxygenation. Neuropediatrics . 1993; 24 19-24
- 62 Graziani L, Streletz L, Baumgart S, Cullen J, McKee L. Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation. J Pediatr . 1994; 125 969-975
- 63 Campbell L, Bunyapen C, Gangarosa M, Cohen M, Kanto W. The significance of seizures associated with ECMO. CNMC ECMO Symposium 26, 1991
- 64 Kumar P, Bedard M, Delaney-Black V, Shankaran S. Post-ECMO electroencephalogram (EEG) as a predictor of neurological outcome. CNMC ECMO Symposium 65, 1994
- 65 Scher M, Kosaburo A, Beggerly M, Hamid M, Steppe D, Painter M. Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. Pediatrics . 1993; 91 128-134
- 66 Ittman P, Schumacher R, Vanderkerhove J. Outcome in newborns following pre-ECMO CPR. CNMC ECMO Symposium 30, 1993
- 67 Stewart D, Davis D, Reese A, Wilkerson S. Neurodevelopmental outcome of extracorporeal life support (ECLS) patients using the Stanford Binet IV. CNMC ECMO Symposium 24, 1993
- 68 Mendoza J, Wilkerson S, Reese A, Vogel R. Outcome of neonates treated with ECMO: longitudinal follow-up from 1 to 3 years of age. CNMC ECMO Symposium 29, 1991
- 69 Wilkerson S, Stewart D, Cook L. Developmental outcome of ECMO patients over a four year span. CNMC ECMO Symposium 23, 1990
- 70 Baumgart S, Graziani L, Streletz L. Right common carotid artery reconstruction following ECMO: structural and vascular imaging electrocephalography and neurodevelopmental correlates to recovery. CNMC ECMO Symposium 27, 1993
- 71 Stanley C, Merton D, Desai S. Four year follow-up doppler ultrasound studies in children who received right common carotid artery (RCCA) reconstruction following neonatal ECMO. CNMC ECMO Symposium 104, 1995