ECMO IN THE NEWBORN

Eugene S. Kim; Charles J. Stolar

doi:10.1055/s-2000-13449

American Journal of Perinatology, Table of Contents

Am J Perinatol 2000; 17(7): 345-356
DOI: 10.1055/s-2000-13449

ECMO IN THE NEWBORN

Eugene S. Kim, Charles J. Stolar

Division of Pediatric Surgery, College of Physicians and Surgeons, Columbia University; Children's Hospital of New York; and New York Presbyterian Hospital, New York, New York

Abstract

ABSTRACT

Since the first use in neonates in 1974, extracorporeal membrane oxygenation (ECMO) has been a life-saving technology for newborns with respiratory and cardiac failure. ECMO has been used to treat a variety of cardio-respiratory problems, including meconium aspiration syndrome (MAS), persistent pulmonary hypertension of the neonate (PPHN), congenital diaphragmatic hernia (CDH), sepsis, and cardiac anomalies. For this group of high-mortality neonates, ECMO has produced a survival of 76% in all newborns treated. This review article will examine the current selection criteria for ECMO, the clinical management of neonates on ECMO and discuss the long-term outcome of neonates treated with ECMO.

KEYWORD

Extracorporeal membrane oxygenation (ECMO) - neonate - respiratory failure

Full Text

References

REFERENCES

1 Extracorporeal Life Support Organization. ECLS Registry Report: International Summary. July, 1999
2 Cilley R E, Zwischenberger J B, Andrews A F, Bowerman R A, Roloff D W, Bartlett R H. Intracranial hemorrhage during extracorporeal membrane oxygenation in neonates. Pediatrics . 1986; 78 699-704
3 Sell L L, Cullen M L, Whittlesey G C. Hemorrhagic complications during extracorporeal membrane oxygenation: Prevention and treatment. J Pediatr Surg . 1986; 21 1087-1091
4 Allmen D, Babcock D, Matsumoto J. The predictive value of head ultrasound in the ECMO candidate. J Pediatr Surg . 1992; 27 36-39
5 Northway W H, Rosan R C, Porter D Y. Pulmonary disease following respiratory therapy of hyaline-membrane disease. N Engl J Med . 1967; 276 357-368
6 Kornhauser M S, Cullen J A, Baumgart S, McKee L J, Gross G W, Spitzer A R. Risk factors for bronchopulmonary dysplasia after extracorporeal membrane oxygenation. Arch Ped Adolesc Med . 1994; 148 820-825
7 Sanders R J, Cox C, Phelps D L, Sinkin R A. Two doses of early intravenous dexamethasone for the prevention of bronchopulmonary dysplasia in babies with respiratory distress syndrome. Pediatr Res . 1994; 36 122-128
8 Wung J T, James L S, Kilchevsky E, James E. Management of infants with severe respiratory failure and persistence of the fetal circulation, without hyperventilation. Pediatrics . 1985; 76 488-494
9 Krummel T M, Greenfield L J, Kirkpatrick B V. Alveolar-arterial oxygen gradients versus the neonatal pulmonary insufficiency index for prediction of mortality in ECMO candidates. J Pediatr Surg . 1984; 19 380-384
10 Beck R, Anderson K D, Pearson G D, Cronin J, Miller M K, Short B L. Criteria for extracorporeal membrane oxygenation in a population of infants with persistent pulmonary hypertension of the newborn. J Pediatr Surg . 1986; 21 297-302
11 Marsh T D, Wilkerson S A, Cook L N. Extracorporeal membrane oxygenation selection criteria: partial pressure of arterial oxygen versus alveolar-arterial oxygen gradient. Pediatrics . 1988; 82 162-166
12 Ortiz R M, Cilley R E, Bartlett R H. Extracorporeal membrane oxygenation in pediatric respiratory failure. Pediatr Clin North Am . 1987; 34 39-46
13 Keszler M, Subramanian K N, Smith Y A. Pulmonary management during extracorporeal membrane oxygenation. Crit Care Med . 1989; 17 495-500
14 Raithel S C, Pennington D G, Boegner E, Fiore A, Weber T R. Extracorporeal membrane oxygenation in children after cardiac surgery. Circulation . 1992; 86 22305-22310
15 Sakai H, Tamura M, Hosokawa Y, Bryan A C, Barker G A, Bohn D J. Effect of surgical repair on respiratory mechanics in congenital diaphragmatic hernia. J Pediatr . 1987; 111 432-438
16 Cartlidge P HT, Mann N P, Kapila L. Preoperative stabilization in congenital diaphragmatic hernia. Arch Dis Child . 1986; 61 1226-1228
17 Breaux Jr W C, Rouse T M, Cain W S, Georgeson K E. Improvement in survival of patients with congenital diaphragmatic hernia utilizing a strategy of delayed repair after medical and/or extracorporeal membrane oxygenation stabilization. J Pediatr Surg . 1991; 26 333-338
18 West K W, Bengston K, Rescorla F J, Engel W A, Grosfeld J L. Delayed surgical repair and ECMO improves survival in congenital diaphragmatic hernia. Ann Surg . 1992; 216 454-462
19 Nakayama D K, Motoyama E K, Tagge E M. Effect of preoperative stabilization on respiratory system compliance and outcome in newborn infants with congenital diaphragmatic hernia. J Pediatr . 1991; 118 793-799
20 Wung J T, Sahni R, Moffitt S T, Lipsitz E, Stolar C J. Congenital diaphragmatic hernia: survival treated with very delayed surgery, spontaneous respiration, and no chest tube. J Pediatr Surg . 1995; 30 406-409
21 Lally K P, Paranka M S, Roden J. Congenital diaphragmatic hernia: stabilization and repair on ECMO. Ann Surg . 1992; 216 569-573
22 Stewart D, Mendoza J, Winston S, Cook L. Extracorporeal life support (ECLS) in infants with total anomalous pulmonary venous drainage (TAPVD): a review of the ELSO registry. CNMC ECMO Symposium 81, 1992
23 Revenis M, Glass P, Short B L. Mortality and morbidity rates among lower birth weight infants (2000 to 2500 grams) treated with extracorporeal membrane oxygenation. J Pediatr . 1992; 121 452-458
24 Grimm P. Feeding difficulties in infants treated with ECMO. CNMC ECMO Symposium 25, 1993
25 Nield T, Hallaway M, Fodera C. Outcome in problem feeders post ECMO. CNMC ECMO Symposium 79, 1990
26 Glass P. Patient neurodevelopmental outcomes after neonatal ECMO. In: Arensman R, Cornish J, eds. Extracorporeal Life Support Boston: Blackwell Scientific Publications 1993: 241-251
27 Tarby T, Waggoner J. Are the common neurologic problems following ECMO related to jugular bulb thrombosis?. CNMC ECMO Symposium 110, 1994
28 Van Meurs K, Robbins S, Reed V, Glass P, O'Brien A, Short B L. Congenital diaphragmatic hernia: long-term outcome of neonates treated with ECMO. CNMC ECMO Symposium 25, 1991
29 Rajasingham S, Reed V, Glass P. Congenital diaphragmatic hernia: outcome post-ECMO at 5 years. CNMC ECMO Symposium 35, 1994
30 Glass P, Wagner A, Papero P. Neurodevelopmental status at age five years of neonates treated with extracorporeal membrane oxygenation. J Pediatr . 1995; 127 447-457
31 Walsh-Sukys M, Bauer R, Cornell D, Friedman H, Stork E, Hack M. Severe respiratory failure in neonates: mortality and morbidity rates and neurodevelopmental outcomes. J Pediatr . 1994; 125 104-110
32 Gershan L, Gershan W, Day S. Airway anomalies after ECMO: bronchoscopic findings. CNMC ECMO Symposium 65, 1992
33 Wagner A, Glass P, Papero P, Coffman C, Kjaer M, Short B L. Neuropsychological outcome of neonatal ECMO survivors at age 5. CNMC ECMO Symposium 31, 1994
34 D'Agostino J, Bernbaum J, Gerdes M. Outcome for infants with congenital diaphragmatic hernia requiring extracorporeal membrane oxygenation: the first year. J Pediatr Surg . 1995; 30 10-15
35 Van Meurs K, Robbins S, Reed V. Congenital diaphragmatic hernia: long-term outcome in neonates treated with extracorporeal membrane oxygenation. J Pediatr . 1993; 122 893-899
36 Atkinson J, Poon M. ECMO and the management of congenital diaphragmatic hernia with large diaphragmatic defects requiring a prosthetic patch. J Pediatr Surg . 1992; 27 754-756
37 Adolph V, Ekelund C, Smith C, Starrett A, Falterman K, Arensman R. Developmental outcome of neonates treated with ECMO. J Pediatr Surg . 1990; 25 43-46
38 Andrews A, Nixon C, Cilley R, Roloff D, Bartlett R. One-to-three year outcome for 14 neonatal survivors of extracorporeal membrane oxygenation. Pediatrics . 1986; 78 692-698
39 Flusser H, Dodge N, Engle W, Garg B, West K. Neurodevelopmental outcome and respiratory morbidity for ECMO survivors at 1 year of age. J Perinatol . 1993; 13 266-271
40 Glass P, Miller M, Short B L. Morbidity for survivors of extracorporeal membrane oxygenation: neurodevelopmental outcome at 12 years of age. Pediatrics . 1989; 83 72-78
41 Griffin M, Minifee P, Landry S, Allison P, Swischuk L, Zwischenberger J. Neurodevelopmental outcome in neonates after ECMO: cranial magnetic resonance imaging and ultrasonography correlation. J Pediatr Surg . 1992; 27 33-35
42 Hofkosh D, Thompson A, Nozza R, Kemp S, Bowen A, Feldman H. Ten years of ECMO: neurodevelopmental outcome. Pediatrics . 1991; 87 549-555
43 Krummel T, Greenfield L, Kirkpatrick B. The early evaluation of survivors after ECMO for neonatal pulmonary failure. J Pediatr Surg . 1984; 19 585-590
44 Schumacher R, Palmer T, Roloff D, LaClaire P, Bartlett R. Follow-up of infants treated with ECMO for newborn respiratory failure. Pediatrics . 1991; 87 451-457
45 Towne B, Lott I, Hicks D, Healey T. Long-term follow-up of infants and children treated with ECMO: a preliminary report. J Pediatr Surg . 1985; 20 410-414
46 Wildin S, Landry S, Zwischenberger J. Prospective, controlled study of developmental outcome in survivors of ECMO: the first 24 months. Pediatrics . 1994; 93 404-408
47 Stolar C J, Crisafi M A, Driscoll Y T. Neurocognitive outcome for neonates treated with extracorporeal membrane oxygenation: are infants with congenital diaphragmatic hernia different?. J Pediatr Surg . 1995; 30 366-372
48 Davis D, Wilkerson S, Stewart D. Neurodevelopmental follow-up of ECMO survivors at 7 years. CNMC ECMO Symposium 34, 1995
49 Stanley C, Brodsky K, McKee L, Gringlas M, Graziani L. Developmental profile of ECMO survivors at early school age and relationship to neonatal EEG status. CNMC ECMO Symposium 33, 1995
50 Hack M, Taylor H, Klein N, Eiben R, Schatschneider C, Mercuri-Minich N. School-age outcomes in children with birthweights under 750 g. N Engl J Med . 1994; 331 753-759
51 Walton J, Hendricks-Munoz K. Profile and stability of sensorineural hearing loss in persistent pulmonary hypertension of the newborn. J Speech Hear Res . 1991; 34 1362-1370
52 Naulty C, Weiss I, Herer G. Progressive sensorineural hearing loss in survivors of persistent fetal circulation. Ear Hear . 1986; 7 74-77
53 Leavitt A, Watchko J, Bennett F, Folson R. Neurodevelopmental outcome following persistent pulmonary hypertension of the neonate. J Perinatol . 1987; 7 88-291
54 Sell E, Gaines J, Gluckman C, Williams E. Persistent fetal circulation: neurodevelopmental outcome. Am J Dis Child . 1985; 139 25-28
55 Marron M, Crisafi M, Driscoll J. Hearing and neurodevelopmental outcome in survivors of persistent pulmonary hypertension of the newborn. Pediatrics . 1992; 90 392-396
56 Bifano E, Pfannenstiel A. Duration of hyperventilation and outcome in infants with persistent pulmonary hypertension. Pediatrics . 1988; 81 657-661
57 Ferrara B, Johnson D, Chang P, Thompson T. Efficacy and neurologic outcome of profound hypocapneic alkalosis for the treatment of persistent pulmonary hypertension in infancy. Pediatrics . 1984; 105 457-461
58 Bernbaum J, Russell P, Sheridan P, Gewitz M, Fox W, Peckham G. Long-term follow-up of newborns with persistent pulmonary hypertension. Crit Care Med . 1984; 12 579-583
59 Desai S, Stanley C, Graziani L, McKee L, Baumgart S. Brainstem auditory evoked potential screening (BAEP) unreliable for detecting sensorineural hearing loss in ECMO survivors: a comparison of neonatal BAEP and follow-up behavioral audiometry. CNMC ECMO Symposium 62, 1994
60 Haney B, Thibeault D, Sward-Comunelli S, Grin T, Stass-Isern M, Grist G. Ocular findings in infants treated with ECMO. CNMC ECMO Symposium 63, 1994
61 Hahn J, Vaucher Y, Bejar R, Coen R. Electroencephalographic and neuroimaging findings in neonates undergoing extracorporeal membrane oxygenation. Neuropediatrics . 1993; 24 19-24
62 Graziani L, Streletz L, Baumgart S, Cullen J, McKee L. Predictive value of neonatal electroencephalograms before and during extracorporeal membrane oxygenation. J Pediatr . 1994; 125 969-975
63 Campbell L, Bunyapen C, Gangarosa M, Cohen M, Kanto W. The significance of seizures associated with ECMO. CNMC ECMO Symposium 26, 1991
64 Kumar P, Bedard M, Delaney-Black V, Shankaran S. Post-ECMO electroencephalogram (EEG) as a predictor of neurological outcome. CNMC ECMO Symposium 65, 1994
65 Scher M, Kosaburo A, Beggerly M, Hamid M, Steppe D, Painter M. Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. Pediatrics . 1993; 91 128-134
66 Ittman P, Schumacher R, Vanderkerhove J. Outcome in newborns following pre-ECMO CPR. CNMC ECMO Symposium 30, 1993
67 Stewart D, Davis D, Reese A, Wilkerson S. Neurodevelopmental outcome of extracorporeal life support (ECLS) patients using the Stanford Binet IV. CNMC ECMO Symposium 24, 1993
68 Mendoza J, Wilkerson S, Reese A, Vogel R. Outcome of neonates treated with ECMO: longitudinal follow-up from 1 to 3 years of age. CNMC ECMO Symposium 29, 1991
69 Wilkerson S, Stewart D, Cook L. Developmental outcome of ECMO patients over a four year span. CNMC ECMO Symposium 23, 1990
70 Baumgart S, Graziani L, Streletz L. Right common carotid artery reconstruction following ECMO: structural and vascular imaging electrocephalography and neurodevelopmental correlates to recovery. CNMC ECMO Symposium 27, 1993
71 Stanley C, Merton D, Desai S. Four year follow-up doppler ultrasound studies in children who received right common carotid artery (RCCA) reconstruction following neonatal ECMO. CNMC ECMO Symposium 104, 1995