[Development of extracorporeal membrane oxygenation for neonates with severe respiratory failure]

Extracorporeal membrane oxygenation (ECMO) is one of the most highly developed artificial organ treatment of the last decade. Especially for severe neonatal respiratory failure, ECMO has become standard treatment in Japan following the same pattern as in the USA. In the USA, more than 12,000 infants have been registered for ECMO treatment by the Extracorporeal Life Support Organization (ELSO), and their total survival rate is above 80%. Recently, to avoid ligating the carotid artery, most neonates who required ECMO have been supported by a veno-venous (V-V) bypass using a double-lumen catheter via the right internal jugular vein into the right atrium. To prevent bleeding complications, the introduction of Nafamostat Mesilate and the development of a heparin-coated system would be advantageous. Progresses in these instruments and perfusing techniques might enlarge the indications of ECMO. We performed an experiment on fetus ECMO as artificial placenta. The fetuses were incubated for 10-237 hours by A-V ECMO using a centrifugal pump successfully and maturation of the lung was revealed. In the future the fetus ECMO could be introduced clinically as a back-up system for fetal surgeries and incubation for extra-premature infants.