Venovenous extracorporeal membrane oxygenation for respiratory failure in inotrope dependent neonates

Neil Roberts, Claire Westrope, Suneel K. Pooboni, Hussain Mulla, Giles J. Peek, Andrew W. Sosnowski, Richard K. Firmin

Research output: Contribution to journalReview article

33 Citations (Scopus)

Abstract

It is often stated that venovenous extracorporeal membrane oxygenation (VV ECMO) should not be used in inotrope dependent patients. It is our practice to use VV ECMO in most patients with respiratory failure even though many of these patients are receiving significant doses of inotropes. Our objective was to review the mode of ECMO in relation to precannulation doses of inotropes administered to neonates treated with ECMO for respiratory failure. Forty-three consecutive case notes were reviewed. Data were collected for basic demographic and ECMO parameters. Inotropic doses were converted to a single score for ease of comparison, with one point equivalent to 1 μg/kg/min dopamine. Forty-three neonates were studied; 37(86%) were treated with VV ECMO and 6 (14%) were treated with VA ECMO. Significant pre-ECMO inotropic support (score > 10) was present in 30 (70%) of the 43 cases. Of these patients, 26 were treated via VV ECMO with a survival rate of 84%, while 4 were treated with VA ECMO with a survival of 75%. Inotrope scores fell to nonsignificant levels (< 10) within 24 hours, regardless of ECMO mode. Mean arterial blood pressure remained above precannulation levels in both groups. VV ECMO allows safe treatment of neonatal respiratory failure in the presence of significant inotropic support. We recommend VV ECMO for neonatal respiratory failure in all cases except where double lumen cannulation is impossible or when septic shock is refractory to inotropic support (i.e., mean blood pressure < 35 mm Hg despite inotrope score of > 100).

Original languageEnglish (US)
Pages (from-to)568-571
Number of pages4
JournalASAIO Journal
Volume49
Issue number5
DOIs
StatePublished - Sep 2003
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Oxygenation
Respiratory Insufficiency
Newborn Infant
Membranes
Dopamine
Survival Rate
Demography
Survival

ASJC Scopus subject areas

  • Biophysics
  • Bioengineering

Cite this

Roberts, N., Westrope, C., Pooboni, S. K., Mulla, H., Peek, G. J., Sosnowski, A. W., & Firmin, R. K. (2003). Venovenous extracorporeal membrane oxygenation for respiratory failure in inotrope dependent neonates. ASAIO Journal, 49(5), 568-571. https://doi.org/10.1097/01.MAT.0000084102.22059.91

Venovenous extracorporeal membrane oxygenation for respiratory failure in inotrope dependent neonates. / Roberts, Neil; Westrope, Claire; Pooboni, Suneel K.; Mulla, Hussain; Peek, Giles J.; Sosnowski, Andrew W.; Firmin, Richard K.

In: ASAIO Journal, Vol. 49, No. 5, 09.2003, p. 568-571.

Research output: Contribution to journalReview article

Roberts, N, Westrope, C, Pooboni, SK, Mulla, H, Peek, GJ, Sosnowski, AW & Firmin, RK 2003, 'Venovenous extracorporeal membrane oxygenation for respiratory failure in inotrope dependent neonates', ASAIO Journal, vol. 49, no. 5, pp. 568-571. https://doi.org/10.1097/01.MAT.0000084102.22059.91
Roberts, Neil ; Westrope, Claire ; Pooboni, Suneel K. ; Mulla, Hussain ; Peek, Giles J. ; Sosnowski, Andrew W. ; Firmin, Richard K. / Venovenous extracorporeal membrane oxygenation for respiratory failure in inotrope dependent neonates. In: ASAIO Journal. 2003 ; Vol. 49, No. 5. pp. 568-571.
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