Advances in neonatal extracorporeal support: the role of extracorporeal membrane oxygenation and the artificial placenta.
This review addresses the history and evolution of neonatal extracorporeal membrane oxygenation (ECMO), with a discussion of the indications, contraindications, modalities, outcomes, and impact of ECMO. Controversies surrounding novel uses of ECMO in neonates, namely ECMO for premature infants and ex utero intrapartum therapy with transition to ECMO, are discussed. The development of an extracorporeal artificial placenta for support of premature infants is presented, including the rationale, research, and challenges. ECMO has had a dramatic effect on the care of critically ill neonates over the past 4 decades, and there is great potential to expand these benefits in the future.
Section of Pediatric Surgery, C.S. Mott Children's Hospital, University of Michigan Health System, B560 MSRBII, 1150 West Medical Center Drive, Ann Arbor, MI 48109, USA.
Brian W
BW
Gray
Andrew W
AW
Shaffer
George B
GB
Mychaliska
D001187:Artificial Organs; D000075202:Contraindications; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006333:Heart Failure / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010920:Placenta / Q000502:physiology*; D011247:Pregnancy; D011379:Prognosis; D012131:Respiratory Insufficiency / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome