ECMO for premature neonates- Are we there yet?

IF 1.4 3区医学 Q3 PEDIATRICS

Seminars in Pediatric Surgery Pub Date : 2023-08-01 DOI:10.1016/j.sempedsurg.2023.151335

Carmen Mesas Burgos , Natalie Rintoul , Lars Mikael Broman

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引用次数: 0

Abstract

Despite ECMO being a well-accepted and established life-saving support for newborns, prematurity (<34 weeks of gestation) and low birth weight <2.0 kg are still considered relative contraindications due to the fear of intracranial bleeding complications.

In the last decades, outcome in extracorporeal life support for pre-term babies has improved, and morbidity dominated by intracranial bleedings has decreased.

With the introduction of new methodologies and technological development, the current ELSO guideline for ECMO (GA >34 w, BW > 2.0 kg) deserves to be challenge.

The authors suggest that Prem-ECMO (GA 32-33) could be considered when restricted to experienced high-volume neonatal ECMO centers, with closed monitoring and rigorous reporting to the ELSO registry, providing close targeting of oxygen delivery for prevention of retinopathy and being active participants in continuous development of technology and devices for improved biocompatibility for use in the neonate.

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早产儿体外膜肺氧合-我们做到了吗?

尽管ECMO是一种被广泛接受和建立的新生儿救生支持，早产(妊娠34周)和低出生体重(2.0 kg)仍被认为是相对禁忌症，因为担心颅内出血并发症。在过去的几十年里，早产儿体外生命支持的结果有所改善，以颅内出血为主的发病率有所下降。随着新方法的引入和技术的发展，目前的ELSO ECMO指南(GA >34 w, BW >2.0公斤)值得挑战。作者建议，如果限于经验丰富的大容量新生儿ECMO中心，可以考虑采用Prem-ECMO (GA 32-33)，并对ELSO登记处进行严密的监测和严格的报告，为预防视网膜病变提供紧密的氧气输送目标，并积极参与技术和设备的持续开发，以改善新生儿的生物相容性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in Pediatric Surgery PEDIATRICS-SURGERY

CiteScore

2.80

自引率

5.90%

发文量

审稿时长

>12 weeks

期刊介绍： Seminars in Pediatric Surgery provides current state-of-the-art reviews of subjects of interest to those charged with the surgical care of young patients. Each bimontly issue addresses a single topic with articles written by the experts in the field. Guest editors, all noted authorities, prepare each issue.