Recommendations for respiratory support in the newborn ( IV ). High frequency ventilation, ex-utero intrapartum treatment (EXIT), extracorporeal membrane oxygenation (ECMO)

Dramatic improvement in morbidity and mortality associated with neonatal respiratory failure has evolved over the last 30 years. Favorable survival statistics can be directly related to the institution and refinement of assisted ventilation techniques. Short-and long-term pulmonary complications continue to be of major concern. New ways to support the neonate in respiratory failure are being investigated. Concentrated efforts are being undertaken to find ways to safely and effectively treat these infants while decreasing the morbidity associated with therapy. Two such therapies, both experimental and controversial, which are gaining widespread recognition, are high-frequency ventilation (HFV) and extracorporeal membrane oxygenation (ECMO)

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Innovative Therapies for Neonatal Respiratory Failure: High-Frequency Ventilation and Extracorporeal Membrane Oxygenation

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-2007-1006198 ◽

1990 ◽

Vol 11 (02) ◽

pp. 127-139 ◽

Cited By ~ 2

Author(s):

Kim Bui ◽

J. Cornish

Keyword(s):

Respiratory Failure ◽

Extracorporeal Membrane Oxygenation ◽

High Frequency ◽

High Frequency Ventilation ◽

Membrane Oxygenation ◽

Innovative Therapies ◽

Frequency Ventilation

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Inter-Hospital Transport of Neonatal Patients on Extracorporeal Membrane Oxygenation: Mobile-ECMO

PEDIATRICS ◽

10.1542/peds.95.4.562 ◽

1995 ◽

Vol 95 (4) ◽

pp. 562-566

Author(s):

Mark J. Heulitt ◽

Bonnie J. Taylor ◽

Sherry C. Faulkner ◽

Lorrie L. Baker ◽

Carl W. Chipman ◽

...

Keyword(s):

Extracorporeal Membrane Oxygenation ◽

Case Series ◽

High Frequency Ventilation ◽

Medical Patients ◽

Retrospective Case ◽

Membrane Oxygenation ◽

Limited Series ◽

Frequency Ventilation ◽

Hospital Transport

Objective. To describe the equipment, personnel requirements, training, management techniques, and logistic problems encountered in the design and implementation of a mobile extracorporeal membrane oxygenation (ECMO) program. Design. This is a report of a technique for the transport of patients on ECMO and a description of our retrospective case series. Settings. The study was conducted at a regional referral children's hospital and ECMO unit. Patients. Thirteen neonatal medical patients with acute respiratory failure were transported with mobile-ECMO. Results. Over a 24-month period, we transported 13 neonatal patients with mobile-ECMO. The reason for transport with mobile-ECMO was inability to convert from high-frequency ventilation (4 of 13), patient already on ECMO (1 of 13), and patient deemed too unstable for conventional transport (8 of 13). Eleven of the 13 patients were transported from other ECMO centers. Of the 13, 9 survived. No major complications during transport were reported for any of the patients. Follow-up data were available on all nine survivors of neonatal mobile- ECMO. Eight of these had normal magnetic resonance imaging scans of the brain; the ninth had a small hemorrhage in the left cerebellum. Conclusion. Our limited series shows that patients can be safely transported with mobile-ECMO. This program does not replace the early appropriate transfer for ECMO-eligible patients to an ECMO center.

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