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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Pediatr. | doi: 10.3389/fped.2018.00263

Neonatal Extracorporeal Membrane Oxygenation (ECMO): a single center experience over 28 years

Friedrich Reiterer1, Elisabeth Resch1, Michaela Haim1, Ute Maurer-Fellbaum1, Michael Riccabona1, Gerfried Zobel1,  Berndt Urlesberger1 and  Bernhard Resch1*
  • 1Medizinische Universität Graz, Austria

ECMO therapy is worldwide declining; hence, its therapeutic use is questioned. We aimed to report our experience with neonatal ECMO due to respiratory failure over a 28 year time period. This is a retrospective single center observational study including all neonates admitted to ECMO due to respiratory failure between 1989 and 2016 at Graz, Austria. Data were collected regarding survival rate, duration of ECMO, complications, length of hospital stay, changes over time, and follow-up.
Sixty-seven neonates were admitted and 43 (64%) needed ECMO - median birth weight 3390 grams (range 1810 – 4150) and gestational age 39 weeks (32 – 43). Survival rate was 65% (28/43); with higher rates in meconium aspiration syndrome (MAS) 89% vs. congenital diaphragmatic hernia (CDH) 46% and septic shock 44% (p=0.005 and p=0.006, respectively). ECMO duration was median 5 days (1-30) and veno-arterial ECMO (52%) dominated. Need for ECMO therapy decreased over time (p<0.001). Complications occurred in 31 (72%) neonates. Five neonates had cerebral hemorrhages (11.4%) and four had cerebral infarction (9.1%). Of 26 survivors 17 (65%) showed normal neurodevelopmental outcome at median follow-up of 73 months. Motor deficits were present in one case, cognitive deficits in 9 (35%). Median length of hospital stay was 78 days in those with deficits and 29 in those with normal neurodevelopmental outcome (p<0.001).
In conclusion, survival rate did not change over the study time but indications for ECMO. Cognitive impairment was the major long-term deficit following neonatal ECMO being associated with longer hospital stay.

Keywords: ECMO complications, Neonatal ECMO, neurodevelopmental outcome, Survival Rate, respiratory failure

Received: 07 Jun 2018; Accepted: 03 Sep 2018.

Edited by:

Utpal S. Bhalala, Baylor College of Medicine, United States

Reviewed by:

Karel Allegaert, University Hospitals Leuven, Belgium
Stefano Ghirardello, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IRCCS), Italy
Javier J. Lasa, Texas Children's Hospital, United States  

Copyright: © 2018 Reiterer, Resch, Haim, Maurer-Fellbaum, Riccabona, Zobel, Urlesberger and Resch. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Bernhard Resch, Medizinische Universität Graz, Graz, Austria, bernhard.resch@medunigraz.at