Clinical Programs
Extracorporeal Membrane Oxygenation
Extracorporeal membrane oxygenation first became a viable treatment for severe neonatal respiratory failure in 1987. Since those early days, the clinicians and researchers in the Section of Neonatology at Baylor College of Medicine have been involved in research and establishing selection criteria. Lisa M. Adcock, M.D., now heads our ECMO Program.
The goal of ECMO is to support tissue oxygenation in infants with severe respiratory failure due to reversible pulmonary disease. The process is to withdraw venous blood from an infant, remove carbon dioxide, add oxygen, and then return the oxygenated blood to the body.
ECMO selection criteria vary among ECMO centers. However, any criteria should determine whether the risk of severe morbidity or mortality without ECMO treatment is greater than the risk of ECMO. Typically, this involves examining arterial oxygenation in relation to the degree of respiratory support. Many centers include criteria for blood lactate levels and/or a postductal PaO2. Gestational age ≥34 weeks and weight ≥2 kg often are specified.
Exclusion criteria include
- presence of significant intracranial hemorrhage,
- uncontrolled bleeding in other locations,
- congenital anomalies or significant central nervous system dysfunction in which ECMO use would appear futile,
- congenital heart disease, or
- pulmonary disease that is not likely to be reversible. This criterion is used as the risk of hemorrhagic and other complications increases with longer ECMO runs.
