[Neonatal extracorporeal membrane oxygenation: 9 years of experience]

Abstract

Introduction: Extracorporeal membrane oxygenation (ECMO) is a rescue therapy for reversible respiratory or cardiac diseases. Neonatal pathologies requiring this technique are different from the ones found later in life.

Objectives: To review the main causes requiring ECMO in the neonatal period, to compare the clinical course depending on the initial illness and to identify the sequelae attributable to this technique.

Material and method: A retrospective review of clinical records of all neonatal patients that received ECMO support in our centre.

Results: 45 neonatal ECMO were performed in our unit between January 2001 and June 2009. Forty techniques were due to respiratory failure, 2 secondary to haemodynamic shock and 3 secondary to sepsis. Veno-venous cannulation was used initially in 24 patients (53.3%). The length of technique varied depending on the underlying disease. Patients with congenital diaphragmatic hernia were in ECMO for longer periods. The overall survival to the technique was 86.3% (38/44 patients), also with differences among diseases. Extracorporeal support was withdrawn in 4 children because of a diagnosis of an irreversible pathology and one because of massive brain haemorrhage. No serious adverse outcomes attributable to the technique were found among survivors.

Conclusions: Survival among newborns supported with ECMO in our hospital is similar to that recorded by the ELSO in 2004, although we use veno-venous cannulation in more than a half of the patients. The percentage of moderate to severely impaired neurodevelopmental outcome among survivors after this technique was low.