New trends in extracorporeal membrane oxygenation (ECMO) for respiratory fa
ilure in the newborn were reviewed. Following a decade of clinical research
, ECMO is now the standard treatment for newborn respiratory failure when a
ll other conventional less-invasive treatment options have been exhausted.
As of July 2000, 15,525 newborns with respiratory failure treated with ECMO
have been entered into the registry of the Extracorporeal Life Support Org
anization with an overall survival rate of 78%. The latest improvement in E
CMO technology in this group of patients includes minimally invasive modes
of vascular access through percutaneous approaches to minimize morbidity. H
owever, with advances in modes of mechanical ventilation, including high-fr
equency ventilation and the introduction of inhaled nitric oxide, the use a
nd necessity for ECMO have clearly diminished for newborn respiratory failu
re.