Related Experiment Video

Updated: Jun 9, 2026

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

Process Analysis of Neonatal and Pediatric Respiratory Extracorporeal Membrane Oxygenation Referrals: An 8-Year

Anna C Dermatidis1, Tom W Bayer2, Verena Varnholt1

  • 1Department of Neonatology, University Children's Hospital Mannheim, University of Heidelberg, Mannheim, Germany.

Critical Care Explorations
|June 8, 2026
PubMed

Insights

Neonatal and pediatric extracorporeal membrane oxygenation (ECMO) referrals were analyzed, revealing higher transfer rates for neonates. Vasoactive-Inotropic Score (VIS) and oxygenation index (OI) may aid ECMO decision-making.

Area of Science:

  • Pediatric critical care medicine
  • Neonatal intensive care
  • Extracorporeal membrane oxygenation (ECMO)

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for critically ill neonates and children.
  • Referral and transfer processes to high-volume ECMO centers are complex and impact patient outcomes.
  • Optimizing these processes is crucial for resource allocation and patient survival.

Purpose of the Study:

  • To evaluate neonatal and pediatric extracorporeal membrane oxygenation (ECMO) referrals and transfers to a high-volume center.
  • To identify factors influencing ECMO decision-making and optimize referral pathways.
  • To analyze patient parameters and outcomes associated with ECMO referrals and transfers.

Main Methods:

  • Retrospective analysis of 348 neonatal and pediatric ECMO referrals between 2015 and 2023.
  • Data collected on patient parameters during referral, transport, ECMO use, and outcomes.
  • Grouped analysis of transferred versus nontransferred neonates and children.

Main Results:

  • Neonates had a higher transfer rate (41.8%) compared to pediatric patients (25.2%).
  • Leading neonatal diagnoses included meconium aspiration syndrome and congenital diaphragmatic hernia; viral pneumonia was most common in pediatric patients.
  • Significant association found between Vasoactive-Inotropic Score (VIS) and ECMO initiation; higher oxygenation index (OI) in transferred ECMO patients (p < 0.001).
  • Neonatal ECMO survival was 90.2% (vs. ELSO 69%); pediatric ECMO survival was 57.1% (vs. ELSO 64%).

Conclusions:

  • Structured referral processes, early telemedical contact, and standardized networks can improve ECMO outcomes.
  • Vasoactive-Inotropic Score (VIS) and oxygenation index (OI) show potential as valuable tools for ECMO decision-making.
  • Optimizing referral pathways and utilizing predictive scores can enhance resource utilization and patient survival in ECMO therapy.
Abstract

Keywords:
extracorporeal membrane oxygenationneonatologyoxygenation indexpediatric intensive caretelemedicine

Related Concept Videos

Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Endoscopic Studies II: Thoracocentesis01:26

Endoscopic Studies II: Thoracocentesis

Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Assessment of Ventilation I: Respiratory Rate01:20

Assessment of Ventilation I: Respiratory Rate

Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Administering Oxygen by Mask01:30

Administering Oxygen by Mask

Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes: