Related Experiment Video
Updated: Aug 24, 2026
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
Published on: January 17, 2025
Cost effectiveness analysis of neonatal extracorporeal membrane oxygenation based on four year results from the UK
1National Perinatal Epidemiology Unit, University of Oxford, Oxford, UK. stavros.petrou@perinat.ox.ac.uk
Insights
Extracorporeal membrane oxygenation (ECMO) is a cost-effective treatment for newborn infants with severe respiratory failure, improving survival and reducing disability. This four-year study confirms ECMO
Area of Science:
- Neonatal care
- Medical technology assessment
- Pediatric intensive care
Background:
- Severe respiratory failure in newborn infants poses significant mortality and morbidity risks.
- Extracorporeal membrane oxygenation (ECMO) is an advanced life support technique for neonates with cardiorespiratory failure.
- Assessing the long-term cost-effectiveness of ECMO is crucial for resource allocation in neonatal intensive care.
Purpose of the Study:
- To evaluate the cost-effectiveness of neonatal extracorporeal membrane oxygenation (ECMO) over a four-year period.
- To determine the incremental cost per life year gained and disability-free life year gained with ECMO.
- To provide evidence for the economic value of ECMO in treating severe respiratory failure in mature newborn infants.
Main Methods:
- A randomized controlled trial comparing ECMO to conventional management in 185 mature newborn infants with severe respiratory failure.
- Follow-up of infants for up to 4 years of age to assess outcomes and costs.
- Cost-effectiveness analysis using incremental cost per additional life year gained and disability-free life year gained.
Main Results:
- Neonatal ECMO significantly reduced death or severe disability (RR=0.64, p=0.004).
- The mean additional health service cost was £17,367 per infant.
- The incremental cost was £16,707 per life year gained and £24,775 per disability-free life year gained.
Conclusions:
- Extracorporeal membrane oxygenation (ECMO) demonstrates robust cost-effectiveness for mature newborn infants with severe respiratory failure at four years.
- The study provides rigorous evidence supporting the use of ECMO as an effective intervention in this patient population.
- The findings support the integration of ECMO into standard care pathways for neonatal respiratory failure.
Objective:
To assess the cost effectiveness of extracorporeal membrane oxygenation (ECMO) for mature newborn infants with severe respiratory failure over a four year time span.
Design:
Cost effectiveness analysis based on a randomised controlled trial in which infants were individually allocated to ECMO (intervention) or conventional management (control) and then followed up to 4 years of age.
Setting:
Infants were recruited from 55 approved recruiting hospitals throughout the United Kingdom. Infants allocated to ECMO were transferred to one of five specialist regional centres. Follow up of surviving infants was performed in the community.
Subjects:
A total of 185 mature (gestational age at birth >or= 35 weeks, birth weight >or= 2000 g) newborn infants with severe respiratory failure (oxygenation index >or= 40).
Main Outcome Measures:
Incremental cost per additional life year gained; incremental cost per additional disability-free life year gained.
Results:
Over four years, the policy of neonatal ECMO was effective at reducing known death or severe disability (relative risk = 0.64; 95% confidence interval 0.47 to 0.86; p = 0.004). After adjustment for censoring and discounting at 6%, the mean additional health service cost of neonatal ECMO was pound 17367 (95% confidence interval pound 12072 to pound 22224) per infant ( pound UK, 2001 prices). Over four years, the incremental cost of neonatal ECMO was pound 16707 ( pound 9828 to pound 37924) per life year gained and pound 24775 ( pound 13106 to pound 69690) per disability-free life year gained. These results remained robust after variations in the values of key variables performed as part of a sensitivity analysis.
Conclusions:
The study provides rigorous evidence of the cost effectiveness of ECMO at four years for mature infants with severe respiratory failure.
