title: ECMO: regional evaluation of need and applicability of selection criteria.
abstract: The need and indications for neonatal extracorporeal membrane oxygenation (ECMO) are controversial. The need for ECMO in two New England states was studied through a review of deaths due to respiratory failure in near- and full-term infants. Vermont averaged 2.4 and Maine averaged 7.4 deaths annually. Neither state demonstrated sufficient respiratory deaths to establish ECMO capability. The number of "potential" ECMO candidates, based on published selection criteria, was studied, and the applicability of criteria was evaluated. A two-year review revealed 16 potential candidates from Maine and 19 from Vermont. No criterion accurately identified nonsurvivors of conventional ventilatory therapy. Only one criterion in one institution demonstrated an association with chronic lung disease. The data demonstrated that published ECMO selection criteria were not applicable in different populations.
authors.affiliation: Department of Pediatrics, University of Vermont, Medical Center Hospital, Vermont 05405.
authors.forename: C H
authors.initials: CH
authors.lastname: Cole
authors.forename: E
authors.initials: E
authors.lastname: Jillson
authors.forename: D
authors.initials: D
authors.lastname: Kessler
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data*; D005240:Feasibility Studies; D005260:Female; D006301:Health Services Needs and Demand; D006302:Health Services Research; D006801:Humans; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008281:Maine; D008297:Male; D010343:Patient Admission / Q000592:standards*; D012131:Respiratory Insufficiency / Q000628:therapy*; D012189:Retrospective Studies; D013673:Technology Assessment, Biomedical; D014707:Vermont