December 1988

ECMO: Regional Evaluation of Need and Applicability of Selection Criteria

Author Affiliations

From the Department of Pediatrics, University of Vermont, Medical Center Hospital of Vermont, Burlington (Drs Cole and Jillson), and the Department of Pediatrics, Maine Medical Center, Portland (Dr Kessler).

Am J Dis Child. 1988;142(12):1320-1324. doi:10.1001/archpedi.1988.02150120074044

• The need and indications for neonatal extracorporeal membrane oxygenation (ECMO) are controversial. The need for ECMO in two New England states was studied through a review of deaths due to respiratory failure in nearand full-term infants. Vermont averaged 2.4 and Maine averaged 7.4 deaths annually. Neither state demonstrated sufficient respiratory deaths to establish ECMO capability. The number of "potential" ECMO candidates, based on published selection criteria, was studied, and the applicability of criteria was evaluated. A two-year review revealed 16 potential candidates from Maine and 19 from Vermont. No criterion accurately identified nonsurvivors of conventional ventilatory therapy. Only one criterion in one institution demonstrated an association with chronic lung disease. The data demonstrated that published ECMO selection criteria were not applicable in different populations.

(AJDC 1988;142:1320-1324)