Neonatal ECMO

The Neonatal ECMO Program is based in the Neonatal Intensive Care Unit (NICU) at Children's Healthcare of Atlanta at Egleston. Here, extracorporeal life support is provided to neonates—children newborn to a maximum age of 28 days old. Because ECMO is risky, it is reserved to treat only infants whose other less invasive, less risky therapies have failed.

Neonatal ECMO Selection Criteria

ECMO was originally reserved for patients who were predicted to have only a 20 percent chance of survival. In general, an infant has better chances of surviving if identified for ECMO therapy early. Current selection criteria at Children's Healthcare of Atlanta includes, but is not limited to:

  • Gestational age of at least 34 weeks
  • 10 or fewer days of mechanical ventilation
  • No severe underlying non-pulmonary disease
  • Down's syndrome does not automatically rule out ECMO. Each patient must be considered individually and meet all inclusion conditions without meeting specific exclusion conditions.
  • Cranial ultrasound with no evidence of intracranial bleeding within a specific range
  • No evidence of severe brain injury
  • No evidence of uncontrolled bleeding or known major bleeding diathesis
  • Severe primary and/or secondary cardiac dysfunction which is life threatening and unresponsive to other available measures

Neonatal ECMO Survival Statistics

NEONATAL ECMO

Patients at Children's

Survived

Children's Survival Rate

ELSO Survival Rate

Barotrauma

1

1

100%

64%

CDH

73

46

63%

52%

Cardiac Failure, Other

1

1

100%

38%

Herpes Septicemia

1

0

0%

64%

Infant RDS

14

11

79%

84%

MAS

98

95

97%

94%

PIE

1

1

100%

71%

Pneumonia

2

1

50%

59%

PPHN

56

47

84%

78%

Pulmonary Hypoplasia

2

2

100%

54%

Respiratory Failure, non trauma

2

0

0%

64%

Sepsis, NOS

20

17

85%

75%

Sepsis, Streptococcal

14

12

86%

75%

Total Neonatal ECMO Patients

285

234

85%

78%