Neonatal Cardiac ECMO in 2019 and Beyond.

Area of Science:

• Pediatrics
• Cardiology
• Critical Care Medicine

Background:

• Extracorporeal Membrane Oxygenation (ECMO) use is rising in neonates with cardiac failure.
• It serves as a crucial bridge to recovery, transplant, or mechanical support for severe heart conditions.
• Neonatal cardiac ECMO is vital for congenital and medical heart diseases, including post-operative stabilization.

Purpose of the Study:

• To review indications, patient selection, and timing for neonatal cardiac ECMO.
• To compare peripheral versus central cannulation strategies.
• To identify predictors of mortality and survival, and discuss supportive care.

Main Methods:

• This is a review article synthesizing current knowledge on neonatal cardiac ECMO.
• It discusses patient selection criteria and cannulation techniques.
• It examines factors influencing outcomes and supportive care strategies.

Main Results:

• Hospital survival for neonatal cardiac ECMO is approximately 40%.
• Outcomes are heavily dependent on the specific indication for ECMO.
• Predictors of mortality and survival are discussed, alongside supportive care insights.

Conclusions:

• Neonatal cardiac ECMO is an established therapy for severe heart failure.
• Careful patient selection, optimal timing, and cannulation strategies are critical for improving survival.
• Long-term neurodevelopmental outcomes require further investigation.