Objective: To summarize the clinical experience of
extracorporeal membrane oxygenation (ECMO) for neonatal refractory
respiratory failure in a single medical center of Southwest
China .
Methods: From June 2020 to November 2021, the clinical data of
neonates with refractory
respiratory failure who received ECMO in the neonatal department of our
hospital were retrospectively reviewed. The
neonates were assigned into the
survival group and the deceased group.Their general profile,
clinical diagnosis ,
laboratory tests, ECMO operation,
complications and
prognosis were compared.
Results: Eight
neonates were included with five successfully withdrawal of ECMO and survived (5/8). For the three deceased
neonates , two discontinued
treatment because of intraventricular
hemorrhage (grade Ⅲ~Ⅳ) and one confirmed
congenital adrenal hyperplasia . No significant differences existed between the
survival and the deceased groups in
oxygenation index (OI), ECMO preparation and operation duration, usage of
heparin ,
red blood cell suspension ,
platelet and
sedative /
analgesic drugs ,
therapeutic hypothermia and ECMO-associated
complications . However, the deceased group had high OI values ( P=0.001), low
lactate clearance ( P=0.005), more
urine output during the first 24 h after ECMO ( P=0.046) and more
fresh frozen plasma usage ( P=0.038). None of the five surviving
children had significant developmental delay and neurological
abnormalities during the 1-year follow-up.
Conclusions: ECMO is effective treating neonatal refractory
respiratory failure . Reducing the
risk of intraventricular
hemorrhage during ECMO may improve the
survival rate .