title: Venoarterial versus venovenous ECMO for neonatal respiratory failure.
abstract: Extracorporeal membrane oxygenation (ECMO) continues to be an important rescue therapy for newborns with a variety of causes of cardio-respiratory failure unresponsive to high-frequency ventilation, surfactant replacement, and inhaled nitric oxide. There are approximately 800 neonatal respiratory ECMO cases reported annually to the Extracorporeal Life Support Organization; venoarterial ECMO has been used in approximately 72% with a cumulative survival of 71% and venovenous has been used in 28% with a survival of 84%. Congenital diaphragmatic hernia is now the most common indication for ECMO. This article reviews the development of the two types of extracorporeal support, venoarterial and venovenous ECMO, and discusses the advantages of each method, the current selection criteria, the procedure, and the clinical management of neonates on ECMO.
authors.affiliation: Department of Neonatology, Children's National Medical Center, The George Washington University School of Medicine, 111 Michigan Ave, NW, Washington, DC 20010. Electronic address: kraisbah@childrensnational.org.
authors.forename: Khodayar
authors.initials: K
authors.lastname: Rais-Bahrami
authors.affiliation: Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA; Medical Director, Neonatal ECMO Program, Lucile Salter Packard Children's Hospital, Palo Alto, CA.
authors.forename: Krisa P
authors.initials: KP
authors.lastname: Van Meurs
mesh_terms: D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D007231:Infant, Newborn; D018579:Patient Selection; D012131:Respiratory Insufficiency / Q000628:therapy*; D016896:Treatment Outcome
keywords: ECMO; neonatal respiratory failure; venoarterial; venovenous