Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure. 100 cases

Ann Surg. 1986 Sep;204(3):236-45. doi: 10.1097/00000658-198609000-00003.

Abstract

Extracorporeal membrane oxygenation (ECMO) was used in the treatment of 100 newborn infants with respiratory failure in three phases: Phase I (50 moribund patients to determine safety, efficacy, and risks); Phase II (30 high risk patients to compare ECMO to conventional ventilation); and Phase III (20 moderate to high risk patients, the current protocol). Seventy-two patients survived including 54% in Phase I, 90% in Phase II, and 90% in Phase III. The major complication was intracranial bleeding, which occurred in 89% of premature infants (less than 35 weeks) and 15% of full-term infants. Best survival results were in persistent fetal circulation (10, 10 survived), followed by congenital diaphragmatic hernia (9, 7 survived), meconium aspiration (44, 37 survived), respiratory distress syndrome (26, 13 survived), and sepsis (8, 3 survived). There were seven late deaths; in follow-up, 63% are normal or near normal, 17% had moderate to severe central nervous system dysfunction, and 8% had severe pulmonary dysfunction. ECMO is now used in several neonatal centers as the treatment of choice for full-term infants with respiratory failure that is unresponsive to conventional management. The success of this technique establishes prolonged extracorporeal circulation as a definitive means of treatment in reversible vital organ failure.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Catheterization / adverse effects
  • Cerebral Hemorrhage / etiology
  • Clinical Trials as Topic
  • Female
  • Follow-Up Studies
  • Humans
  • Infant, Newborn
  • Male
  • Oxygenators, Membrane* / adverse effects
  • Respiratory Distress Syndrome, Newborn / therapy*