Extracorporeal membrane oxygenation for Chinese neonates with severe respiratory and cardiac failure

Objective: We aimed to outline the experience with extracorporeal membrane oxygenation (ECMO) for respiratory and cardiac failure in neonates in our institution and compare our results with those from other countries.

Method: The clinical data of 28 neonates who required ECMO assistance were studied retrospectively.

Results: A total of 28 neonates underwent support with veno-arterial ECMO, including 14 cardiac support and 14 respiratory support. The neonates with a median age of 5 days (1-28 days) and a median weight of 3.3 kg (2.4-4.2 kg). Of these neonates, 4 were female, and 24 were male. Among the neonates. For neonates requiring ECMO support for cardiac conditions, 9 survived, resulting in a 64% survival rate. In contrast, for those requiring ECMO support for respiratory conditions, 6 survived, indicating a 42% survival rate. The survivors exhibited a significant reduction in lactic acid levels within the first 24 h. In the 15 successful weaning neonates, four neonates died at the end of the study; one was for the cardiac function failure; two were for the respiratory failure; one was given up for Bipedal necrosis; the other 11 neonates were successful discharge. Notably, two neonates underwent ECMO ventilation in the prone position without experiencing any complications.

Conclusion: The utilization of ECMO support in neonates experiencing severe respiratory and cardiac failure efficiently improves cardiopulmonary function and significantly reduces mortality rates among critically ill neonates. The neonates with a respiratory indication in our study have a lower survival rate than other reported in the literature. Monitoring the trend in lactate levels following ECMO support proves valuable in estimating the prognosis of affected children.