Extracorporeal Membrane Oxygenation

Conclusion

As of January 2003, more than 19,000 neonates (74% survival) and 4,800 paediatric patients (48% survival) have been treated with ECMO. In the neonatal population, MAS is the most common indication for ECMO and carries with it a survival rate of 94%. Other frequent diagnosis (with survival rates in parentheses) include PPHN (79%), sepsis (75%), and CDH (54%). Viral pneumonia is the most common aetiology amongst the paediatric population requiring ECMO and has a 62% survival. Aspiration carries the greatest survival at 65%,where as non-ARDS respiratory failure has a 47% survival, ARDS 55%, and bacterial pneumonia 52% survival. Cardiac patients have an overall survival of 39%. Specifically, congenital defects have a 38% survival, bridge to transplant 43%, cardiomyopathy 49%, and the highest survival rate is for myocarditis, 58%.

Recent medical advances, such as permissive hypercapnea and the use of oscillatory ventilation have spared numerous babies from ECMO, yet many children still benefit from this modality. In summary, any patient with reversible cardiopulmonary disease, who meets criteria, should be considered an ECMO candidate. ECMO provides an excellent opportunity to provide “rest” to the cardiopulmonary systems and allows the patient to recover using pharmacologic and surgical therapies.