title: Extracorporeal membrane oxygenation in 61 neonates: Single-center experience.
abstract: BACKGROUND
  There have been few reports on the outcome of extracorporeal membrane oxygenation (ECMO) in newborn Japanese infants.
  
  
  METHODS
  A review was carried out of 61 neonates with ECMO between January 1995 and December 2015 at a single center. ECMO was used in neonates with oxygenation index >20 after conventional treatment. Background factors, such as etiology, vascular access mode (veno-venous [VV] or veno-arterial [VA]), number of days with ECMO, and early ECMO (within 24 h after birth), were analyzed in relation to outcome with respect to survival to hospital discharge (SHD).
  
  
  RESULTS
  Survival to hospital discharge was achieved in 35 infants (57%), while the remaining 26 died during hospital stay. Gestational age at birth was significantly higher and number of days with ECMO was significantly lower in SHD infants compared with those with adverse outcome (median, 4.0 vs 5.5 days, respectively; P = 0.008). The SHD rate was significantly higher for those with VV than VA vascular access mode (78%, 18/23 vs 45%, 17/38, respectively; P = 0.016), and for those with than without early ECMO (72%, 28/39 vs 32%, 7/22, respectively; P = 0.003). The SHD rate was relatively high in neonates with meconium aspiration syndrome (86%, 12/14), persistent pulmonary hypertension associated with hypoxic ischemic encephalopathy (75%, 6/8), and emphysema (80%, 4/5). On stepwise logistic regression analysis two independent factors of SHD were identified: early ECMO (OR, 9.63; 95%CI: 2.47-37.6) and ECMO length <8 days (OR, 8.05; 95%CI: 1.94-33.5).
  
  
  CONCLUSIONS
  Neonates with early ECMO and those with ECMO duration <8 days may benefit from ECMO with respect to SHD.
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Hirakawa
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ibara
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Tokuhisa
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Fukuda Hospital, Kumamoto, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Maede
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Takako
authors.initials: T
authors.lastname: Kuwahara
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Chie
authors.initials: C
authors.lastname: Ishihara
authors.affiliation: Department of Pediatric Surgery, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Noguchi
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Naitou
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Masakatsu
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Kibe
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Neonatology, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Kurimoto
authors.affiliation: Department of Obstetrics, Perinatal Medical Center, Kagoshima City Hospital, Kagoshima, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Kamitomo
authors.affiliation: Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Cho
authors.affiliation: Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D012127:Respiratory Distress Syndrome, Newborn / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
keywords: extracorporeal life support; meconium aspiration syndrome; neonatal complication; respiratory depression; respiratory failure