What are the selection criteria for neonatal ECMO?

Updated: Dec 21, 2017
  • Author: Edwin Rodriguez-Cruz, MD; Chief Editor: Stuart Berger, MD  more...
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Answer

Answer

Selection criteria for neonates include the following:

  • Gestational age of 34 weeks or more

  • Birth weight of 2000 g or higher

  • No significant coagulopathy or uncontrolled bleeding

  • No major intracranial hemorrhage (grade 1 intracranial hemorrhage)

  • Mechanical ventilation for 10-14 days or less

  • Reversible lung injury

  • No lethal malformations

  • No major untreatable cardiac malformation

  • Failure of maximal medical therapy

Failure to meet these criteria is a relative contraindication for ECMO.

Qualifying patient criteria for ECMO are applied only when the infant has reached maximal ventilatory support of 100% oxygen (fraction of inspired oxygen [FiO2] equals 1) with peak inspiratory pressures (PIP) often as high as 35 cm water. They include the alveolar-arterial gradient, the oxygenation index, and acute deterioration.


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