title: Successful Use of Extracorporeal Membrane Oxygenation in a Neonate With Arterial pH Less Than 6.6.
abstract: Challenges in extracorporeal membrane oxygenation (ECMO) support include defining appropriate patient selection criteria and prognostic factors. Severe acidosis prior to ECMO deployment is often considered a relative contraindication and an independent predictor of mortality. We present a case of a term infant, with persistent pulmonary hypertension of the newborn with severe pre-ECMO acidosis (arterial blood pH 6.596) in whom venoarterial ECMO was instituted successfully without major circuit or patient-associated complications. At seven months of age, he exhibited age-appropriate neurodevelopmental milestones. We therefore report this instance of successful use of ECMO in the setting of extreme acidosis.
authors.affiliation: Department of Pediatrics, KK Women's and Children's Hospital, Singapore joellim@gmail.com.
authors.forename: Joel Kian
authors.initials: JK
authors.lastname: Boon Lim
authors.affiliation: Department of Pediatric Subspecialties, Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore Duke-NUS Graduate School of Medicine, Singapore.
authors.forename: Jan Hau
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Pediatric Subspecialties, Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore Duke-NUS Graduate School of Medicine, Singapore.
authors.forename: Yee Hui
authors.initials: YH
authors.lastname: Mok
authors.affiliation: Department of Pediatric Subspecialties, Children's Intensive Care Unit, KK Women's and Children's Hospital, Singapore Duke-NUS Graduate School of Medicine, Singapore.
authors.forename: Yoke Hwee
authors.initials: YH
authors.lastname: Chan
mesh_terms: D000138:Acidosis / Q000097:blood* / Q000209:etiology / Q000628:therapy; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007231:Infant, Newborn; D008297:Male; D010547:Persistent Fetal Circulation Syndrome / Q000097:blood / Q000150:complications / Q000628:therapy*
keywords: acidosis; extracorporeal membrane oxygenation; neonate; persistent pulmonary hypertension