• C Flamant, P Nolent, F Hallalel, C Lardeux, J Y Chevalier, and S Renolleau.
• Service de réanimation néonatale et pédiatrique, hôpital d'enfants Armand-Trousseau, AP-HP, 26, avenue du Docteur A.-Netter, 75571 Paris 12, France. cyril.flamant@trs.ap-hop-paris.fr
• Arch Pediatr. 2004 Apr 1; 11 (4): 308-14.

UnlabelledOver the last decade, several new therapies including exogenous surfactant therapy, inhaled nitric oxide and high-frequency ventilation have become available for the treatment of neonatal pulmonary failure. The aim of this retrospective study was to evaluate to what extent these modalities have impacted the use of neonatal extracorporeal membrane oxygenation at our institution and to discuss the role of ECMO in 2003 in the management of newborn infants with refractory hypoxemia.Population And MethodsTwo hundred and twenty six newborn infants treated by ECMO before 15 days of life and during more than 24 h in our intensive care unit were retrospectively included from two time periods (group 1: 1988-1993 and group 2: 1996-2003).ResultsAs compared with the first group, the number of newborns supported by ECMO in the second group has clearly diminished and their severity has increased. Overall survival rate was 80% in the first group and 69% in the second group. Meconium aspiration syndrome remains the major indication for ECMO (44%). Pulmonary sequelae, assessed by bronchopulmonary dysplasia rate (41%) are more frequent that neurologic sequelae (4.8%).ConclusionECMO remains an useful technique in the management of newborn infants with refractory hypoxemia, with a consideration to institute ECMO early in order to increase survival rate.

19 keywords...

hide…