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Extracorporeal membrane oxygenation (ECMO) for non‐ECMO intensive care nurseries
Author(s) -
THAMBAPILLAI E.,
DOYLE L. W.,
MURTON L. J.
Publication year - 1990
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/j.1440-1754.1990.tb01068.x
Subject(s) - extracorporeal membrane oxygenation , medicine , critically ill , intensive care , hypoxia (environmental) , pediatrics , emergency medicine , intensive care medicine , anesthesia , chemistry , organic chemistry , oxygen
An extracorporeal membrane oxygenation (ECMO) centre has been established in the sole outborn‐only level 3 nursery in Melbourne. In the absence of other guidelines, an infant may qualify for ECMO if the expected mortality, based on assessment of the severity of hypoxia, exceeds 80%. However, for a non‐ECMO centre, this involves the additional hazard of transport for an already critically‐ill infant. The aim of this study was to determine the predictors of at least 80% mortality in babies who might have qualified for ECMO but who were cared for in a non‐ECMO level 3 nursery. Regardless of the severity or duration of hypoxia, we were unable to identify a group of infants whose mortality exceeded 80%. Since outborn infants were disproportionately over‐represented amongst those who might qualify for ECMO, it would be advisable to admit preferentially those born outside the level 3 perinatal centres who might qualify for ECMO directly to the ECMO centre. For infants born within our level 3 perinatal centre, it is recommended not to transfer those who might qualify based on data from other centres until the exact role of ECMO is determined. Alternatively, a randomized controlled trial of transfer versus non‐transfer to the ECMO centre for severely hypoxic infants cared for in non‐ECMO level 3 nurseries could be considered.