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Updated: Feb 14, 2026

Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
Published on: October 24, 2018
Rapid resolution of hyperammonemia in neonates using extracorporeal membrane oxygenation as a platform to drive
Jamie R Robinson1,2, Patricia C Conroy3,4, Daphne Hardison5
1Department of Biomedical Informatics, Vanderbilt University, Nashville, USA. jamie.r.robinson@vanderbilt.edu.
Objective:
We aimed to clarify the impact of extracorporeal membrane oxygenation (ECMO) as a platform to drive hemodialysis (HD) for ammonia clearance on outcomes of neonates with severe hyperammonemia.
Study Design:
All neonates treated for hyperammonemia at a single children's hospital between 1992 and 2016 were identified. Patient characteristics and outcomes were compared between those receiving medical management or ECMO/HD.
Result:
Twenty-five neonates were treated for hyperammonemia, of which 13 (52%) received ECMO/HD. Peak ammonia levels among neonates treated with ECMO/HD were significantly higher than those medically managed (1041 [IQR 902-1581] μmol/L versus 212 [IQR 110-410] μmol/L; p = 0.009). Serum ammonia levels in the ECMO/HD cohort declined to the median of medically managed within 4.5 (IQR 2.9-7.0) hours and normalized within 7.3 (IQR 3.6-13.5) hours. All neonates survived ECMO/HD, and nine (69.2%) survived to discharge.
Conclusion:
ECMO/HD is an effective adjunct to rapidly clear severe hyperammonemia in newborns, reducing potential neurodevelopmental morbidity.
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