title: Use of extracorporeal membrane oxygenation to rescue a newborn with early-onset group B streptococcal sepsis and cardiopulmonary failure.
abstract: Group B streptococcal (GBS) infection is an important cause of perinatal morbidity and mortality. We report the use of extracorporeal membrane oxygenation (ECMO) to rescue a newborn with refractory GBS sepsis and meningitis who developed cardiopulmonary failure. This 2-day-old infant weighed 2640 g and was born to a healthy mother at full term. Respiratory distress, hypotension, and persistent pulmonary hypertension developed on the second day of life. The clinical condition deteriorated rapidly despite conventional treatment, and venoarterial ECMO was established to rescue this moribund newborn. During ECMO, the patient regained stable hemodynamics and good oxygenation, and infection was controlled. ECMO was used for 90 hours and the baby was weaned smoothly. Neurologic assessment after ECMO revealed hydrocephalus, abnormal electroencephalogram, and increased brain auditory evoked potential threshold. This report emphasizes that ECMO may be considered to rescue neonatal patients with cardiopulmonary failure due to GBS sepsis. Possible neurologic complications after ECMO should be carefully monitored.
authors.affiliation: Department of Pediatrics, Far Eastern Memorial Hospital, Taipei County, Taiwan.
authors.forename: Yu-Cheng
authors.initials: YC
authors.lastname: Lin
authors.forename: Juine-Yih
authors.initials: JY
authors.lastname: Ma
authors.forename: Shu-Jen
authors.initials: SJ
authors.lastname: Yeh
authors.forename: Kuan-Ming
authors.initials: KM
authors.lastname: Chiu
authors.forename: Shu-Hsun
authors.initials: SH
authors.lastname: Chu
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016920:Meningitis, Bacterial / Q000628:therapy; D010547:Persistent Fetal Circulation Syndrome / Q000628:therapy*; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy*; D018805:Sepsis / Q000382:microbiology*; D013290:Streptococcal Infections / Q000150:complications*; D013292:Streptococcus agalactiae