Left and right ventricular output in newborn infants undergoing extracorporeal membrane oxygenation

Extracorporeal membrane oxygenation (ECMO) has gained a place as an alternative mode of treatment for newborn infants with life-threatening respiratory failure who do not respond to maximal conventional ventilatory support. To determine any possible changes in cardiac performance during the course of ECMO treatment, we evaluated left and right ventricular output in 10 newborn infants with pulsed Doppler ultrasound before, during, and after ECMO. Birth weight ranged from 2.5 to 4.2 kg and gestational age from 35 to 42 wk. During ECMO, left and right ventricular output decreased proportionally to the amount of bypass flow provided (r = -.82 and -.83, respectively; p less than .001), and were accompanied by a decrease in left ventricular contractility. Pulsed Doppler echocardiography provides a noninvasive method to estimate ventricular outputs during ECMO and to evaluate the response of both ventricles to volume loading during weaning from ECMO.