Neonatal respiratory extracorporeal membrane oxygenation and primary diagnosis: trends between two decades

J Perinatol. 2020 Feb;40(2):269-274. doi: 10.1038/s41372-019-0547-y. Epub 2019 Nov 7.


Objective: Examine changing neonatal respiratory extracorporeal membrane oxygenation (ECMO) practice trends and outcomes.

Study design: Retrospective cohort study comparing neonatal respiratory ECMO in the 1990 and 2010 decades (1994-1995 and 2014-2015). Patients ≤ 30 days of life, reported to the Extracorporeal Life Support Organization registry, were included.

Results: Four thousand one hundred and twenty-five patients met inclusion criteria. ECMO cases decreased by 33%. The primary ECMO diagnosis changed significantly over time (p < 0.0001). Survival to discharge decreased (76 vs 67%, p < 0.0001) and ECMO duration increased (131 vs 158 h, p < 0.001). Lung recovery was the most common reason to discontinue ECMO although family request for withdrawal and a diagnosis considered "incompatible with life" was increasingly common in the 2010s.

Conclusion: Although the use of ECMO for neonatal respiratory diagnoses has decreased over time, its use has increased for patients with more complex diagnoses and ECMO duration is longer. ECMO continues to be an important supportive therapy, improved understanding of which patients would benefit most is needed.

Publication types

  • Comparative Study

MeSH terms

  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / trends*
  • Humans
  • Infant, Newborn
  • Persistent Fetal Circulation Syndrome / therapy
  • Pneumonia / therapy
  • Respiratory Distress Syndrome, Newborn / therapy
  • Respiratory Insufficiency / mortality
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • Treatment Outcome
  • Withholding Treatment / trends