How many neonates in New Zealand would qualify for extracorporeal membrane oxygenation?
OBJECTIVE
To estimate how many neonates in New Zealand would qualify for extracorporeal membrane oxygenation (ECMO), using both standard published criteria and locally derived criteria.


METHODS
Retrospective chart review of all babies with a birth weight over 2000 g admitted to neonatal intensive care in Auckland from June 1990 to June 1993. Ventilation and blood gas indices were calculated for all babies who were ventilated in 100% O2 for more than 4 hours and who met the basic criteria for ECMO (less than 1 week old with no neurological or chromosomal problems). These indices were compared with published ECMO criteria. Using a threshold of an 80% mortality, Auckland criteria for ECMO were derived.


RESULTS
Of the published criteria for ECMO, only an oxygenation index of greater than 40 for 4 hours predicted a mortality of more than 80% in our population. From our own findings a PaO2 < 6.5 kPa for 4 hours predicted a mortality of 79%.


CONCLUSIONS
Approximately 19 neonates might qualify for ECMO in New Zealand each year.
Bloomfield
G P
GP
Department of Paediatrics, National Women's Hospital, Auckland.
Harding
J E
JE
D015199:Extracorporeal Membrane Oxygenation / Q000592:standards; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009520:New Zealand; D010100:Oxygen / Q000097:blood; D012131:Respiratory Insufficiency / Q000097:blood / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies
D010100:Oxygen