THE INFLUENCE OF LUNG INJURY DUE TO MECHANICAL VENTILATION ON THE INITIATION OF ECMO

Before the entry criteria for extracorporeal membrane oxygenation (ECM O) are met, newborns may require aggressive mechanical ventilation whi ch may result in lung injury. The question arises whether the presence of a pneumothorax in these infants plays a role in the prognosis. Of the 21 newborns transferred to our hospital for ECMO, 8 were treated w ith ECMO. 9 of the 21 newborns developed a pneumothorax with conventio nal ventilation and 6 of these,a newborns subsequently required ECMO. Infants who developed a pneumothorax but did not meet ECMO criteria an d remained in the oxygenation index (OI) range between 25 and 40 for m ore than 2 days had a poorer prognosis. If adequate oxygenation cannot be attained with acceptable mechanical ventilation and a more aggress ive ventilation results in a pneumothorax, ECMO should be considered e ven if the oxygenation index is below 40.