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Published on: October 11, 2011
How many neonates in New Zealand would qualify for extracorporeal membrane oxygenation?
1Department of Paediatrics, National Women's Hospital, Auckland.
Aim:
To estimate how many neonates in New Zealand would qualify for extracorporeal membrane oxygenation (ECMO), using both standard published criteria and locally derived criteria.
Methods:
Retrospective chart review of all babies with a birth weight over 2000 g admitted to neonatal intensive care in Auckland from June 1990 to June 1993. Ventilation and blood gas indices were calculated for all babies who were ventilated in 100% O2 for more than 4 hours and who met the basic criteria for ECMO (less than 1 week old with no neurological or chromosomal problems). These indices were compared with published ECMO criteria. Using a threshold of an 80% mortality, Auckland criteria for ECMO were derived.
Results:
Of the published criteria for ECMO, only an oxygenation index of greater than 40 for 4 hours predicted a mortality of more than 80% in our population. From our own findings a PaO2 < 6.5 kPa for 4 hours predicted a mortality of 79%.
Conclusion:
Approximately 19 neonates might qualify for ECMO in New Zealand each year.
