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On My Mind
April 2014

Extracorporeal Membrane Oxygenation and an Angel

Author Affiliations
  • 1Treuman Katz Center for Pediatric Bioethics, Seattle Children’s Hospital, Seattle, Washington
JAMA Pediatr. 2014;168(4):305. doi:10.1001/jamapediatrics.2013.4665

“We have a baby who needs ECMO,” says a voice on the other end of the line. I recognize the sound of his adrenaline rush, just as my own occurs. We often take calls from other neonatal intensive care units requesting a transfer to our center. The calls for extracorporeal membrane oxygenation (ECMO) are usually the worst.

As I take more information, my heart sinks. This infant has a diaphragmatic hernia, a congenital defect in the diaphragm that leads to severe abnormalities in the lungs. His blood gases have been extremely abnormal since birth—almost 18 hours ago. We have no way of knowing what that has done to his brain. His name is Angel.

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