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

Journal of Perinatology volume 40, pages 269–274 (2020)Cite this article

Subjects

Abstract

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.

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Acknowledgements

Authors acknowledge ECMO Registry of Extracorporeal Life Support Organization (ELSO), Ann Arbor, Michigan for providing the patient data for the study and Kayla Seever for assistance with paper preparation.0-159/00044489509:3.

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Authors and Affiliations

  1. Division of Neonatology, Children’s Mercy, Kansas City, MO, USA

    Jotishna Sharma, Barb Haney, Julie Weiner & Eugenia Pallotto

  2. Department of Pediatrics, University of Missouri School of Medicine, Kansas City, MO, USA

    Jotishna Sharma, Julie Weiner & Eugenia Pallotto

  3. Department of Health Services and Outcomes Research, Children’s Mercy, Kansas City, MO, USA

    Ashley Sherman

  4. Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA

    Anisha Rimal

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  1. Jotishna Sharma
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Correspondence to Jotishna Sharma.

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Sharma, J., Sherman, A., Rimal, A. et al. Neonatal respiratory extracorporeal membrane oxygenation and primary diagnosis: trends between two decades. J Perinatol 40, 269–274 (2020). https://doi.org/10.1038/s41372-019-0547-y

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