Extracorporeal membrane oxygenation in 61 neonates: Single-center experience

Background There have been few reports regarding outcomes after extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants. Methods A review of 61 neonates with ECMO through January 1995 at a single center was performed. ECMO was used in neonates with oxygenation index > 20 after conventional treatments. Background factors, such as etiology, vascular access mode (veno–venous [VV] or veno–arterial [VA]), number of days with ECMO, and early ECMO (within 24 hours after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD). Results SHD was achieved in 35 (57%) infants, while the remaining 26 died during the hospital stay. Gestational age at birth was significantly higher and number of days with ECMO was significantly lower in SHD infants compared to those with adverse outcome (median, 4.0 vs. 5.5 days, respectively, P = 0.008). The SHD rate was significantly higher for those with VV than VA (78% [18/23] vs. 45% [17/38], respectively, P = 0.016), and for those with than without early ECMO (72% [28/39] vs. 32% [7/22], respectively, P = 0.003). The SHD rate was relatively high in neonates with meconium aspiration syndrome (MAS) (86% [12/14]), persistent pulmonary hypertension (PPHN) associated with hypoxic ischemic encephalopathy (HIE) (75% [6/8]), and emphysema (80% [4/5]). Stepwise logistic regression analysis identified two independent risk factors for SHD including early ECMO (OR [95%CI], 9.63 [2.47 – 37.6]) and ECMO length < 8 days (8.05 [1.94 – 33.5]). Conclusions Neonates having early ECMO and those with ECMO duration less than 8 days may have benefited from ECMO with respect to SHD. This article is protected by copyright. All rights reserved.