Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure

R. P. Foglia, H. S. Bjerke, R. E. Kelly, J. D. Phillips, L. Barcliff, E. W. Fonkalsrud

Research output: Contribution to journalArticle

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Abstract

We report 18 consecutive neonates with severe respiratory failure due to pulmonary hypertension treated with extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation was begun at 52 ± 36 hours of age with an arterial partial pressure of oxygen (PO2) of 36 ± 14 mm Hg despite maximal pharmacologic and ventilator support (inspired fraction of oxygen [FiO2], 0.99 ± 0.03; respiratory rate, 98 ± 31/min; and positive inspiratory pressure, 54 ± 11 cm of water). With initial flows of 130 ± 17 mL/kg per minute, ventilator settings were reduced to the following: FiO2, 0.30; respiratory rates, 15/min; and positive inspiratory pressure, 24 cm of water. Support using extracorporeal membrane oxygenation was gradually reduced to 22% or initial flows and arterial blood samples showed pH 7.48 ± .05, PO2 of 106 ± 27 mm Hg, and PCO2 of 36 ± 5 mm Hg just prior to decannulation. After 107 ± 45 hours, extracorporeal membrane oxygenation was stopped and infants were extubated 61 ± 53 hours (median, 46 hours) afterward. There was one death (94.4% survival rate); all survivors were discharged and underwent a follow-up examination at 1 to 27 months of age. Complications included two intracranial hemorrhages (one death and one asymptomatic), one patent ductus arteriosis requiring ligation on extracorporeal membrane oxygenation, and chronic lung disease in one patient. In selected neonates, extracorporeal membrane oxygenation allows for resolution of pulmonary hypertension, results in improved survival, and is associated with a low incidence of chronic lung disease. Extracorporeal membrane oxygenation should be considered in the treatment of severe respiratory failure.

Original languageEnglish (US)
Pages (from-to)1286-1292
Number of pages7
JournalArchives of Surgery
Volume125
Issue number10
StatePublished - 1990

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Extracorporeal Membrane Oxygenation
Respiratory Insufficiency
Mechanical Ventilators
Respiratory Rate
Pulmonary Hypertension
Therapeutics
Lung Diseases
Chronic Disease
Newborn Infant
Oxygen
Pressure
Patent Ductus Arteriosus
Water
Intracranial Hemorrhages
Partial Pressure
Ligation
Survivors
Arterial Pressure
Survival Rate
Survival

ASJC Scopus subject areas

  • Surgery

Cite this

Foglia, R. P., Bjerke, H. S., Kelly, R. E., Phillips, J. D., Barcliff, L., & Fonkalsrud, E. W. (1990). Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure. Archives of Surgery, 125(10), 1286-1292.

Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure. / Foglia, R. P.; Bjerke, H. S.; Kelly, R. E.; Phillips, J. D.; Barcliff, L.; Fonkalsrud, E. W.

In: Archives of Surgery, Vol. 125, No. 10, 1990, p. 1286-1292.

Research output: Contribution to journalArticle

Foglia, RP, Bjerke, HS, Kelly, RE, Phillips, JD, Barcliff, L & Fonkalsrud, EW 1990, 'Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure', Archives of Surgery, vol. 125, no. 10, pp. 1286-1292.
Foglia RP, Bjerke HS, Kelly RE, Phillips JD, Barcliff L, Fonkalsrud EW. Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure. Archives of Surgery. 1990;125(10):1286-1292.
Foglia, R. P. ; Bjerke, H. S. ; Kelly, R. E. ; Phillips, J. D. ; Barcliff, L. ; Fonkalsrud, E. W. / Extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure. In: Archives of Surgery. 1990 ; Vol. 125, No. 10. pp. 1286-1292.
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