Extracorporeal Membrane Oxygenation for Neonatal Respiratory Failure

Abstract

Recent medical advances, such as permissive hypercapnia, inhaled nitric oxide, and the use of oscillatory ventilation, have spared numerous patients from ECMO, yet many children still benefit from this modality. Patients with reversible cardiopulmonary disease, who meet criteria, should be considered ECMO candidates. As of January 2015, 27,728 neonates (74% survival) and 6,569 pediatric patients (57% survival) have been treated with ECMO for respiratory failure and 13,124 neonatal and pediatric patients for cardiac failure. ECMO provides an excellent opportunity to provide “rest” to the cardiopulmonary systems thus avoiding the additional lung or cardiac injury which otherwise would be necessary to maintain life support. This chapter outlines the indications, contraindications, management approach, and complications associated with ECMO as well as the various bypass configurations and cannulation strategies which may be employed.