Management of persistent pulmonary hypertension in newborns with ECMO support: a single center's experience
To summarize the experience of management of persistent pulmonary hypertension of the newborn (PPHN) with extracorporeal membrane oxygenation (ECMO) support.
We presented three neonates with PPHN supported by ECMO in our center. Medical records and patient management notes were retrospectively reviewed.
For two neonates with congenital diaphragmatic hernia (CDH), diaphragm repair surgery was done under ECMO support. One patient was weaned from ECMO after 73 hours, and recovered well at the last follow-up after 1 year. The other patient was weaned from ECMO after 167 hours, and he died from septic shock 21 days after decannulation. For the neonate with idiopathic PPHN, ECMO was withdrawn successfully.
ECMO is an effective rescue means for refractory PPHN. Appropriate intervention timing, accurate coagulation, and volume management are important.
KeywordsExtracorporeal membrane oxygenation Persistent pulmonary hypertension of the newborn
We thank the ECMO team members at the Children’s Hospital, Zhejiang University School of Medicine. We thank the NICU and CCU physicians and nurses at Children’s Hospital, Zhejiang University School of Medicine, for their cooperation. No financial benefits have been received from any party related directly or indirectly to the subject of this article.
YLF designed the study, collected, and analyzed the medical records, and wrote the paper. LR and SQ designed the study and managed the writing. FY collected the medical records.
National Science and Technology Foundation of China (2012BAI04B05), Science and Technology Planning Project of Zhejiang Province, China (LGF18H020005).
Compliance with ethical standards
This article was approved by the Ethics Committee of the Children’s Hospital of Zhejiang University School of Medicine.
Conflict of interest
Written informed consents for reporting these cases were obtained from their parents.
- 2.Extracorporeal Life Support Organization. ECLS Registry report international summary [DB/OL]. http://www.elso.med.umich.edu/default.htm. Accessed 5 Feb 2018.
- 5.Annich Gail, Lynch William, MacLaren Graeme, Wilson Jay M, Bartlett Robert H. Extracorporeal cardiopulmonary support in critical care. 4th ed. Michigan: Extracorporeal Life Support Organization; 2012.Google Scholar
- 9.Vrancken SL, Heijst AF, Zegers M, der Staak FH, Liem KD, van Heijst AF, et al. Influence of volume replacement with colloids versus crystalloids in neonates on venoarterial extracorporeal membrane oxygenation on fluid retention, fluid balance, and ECMO runtime. ASAIO J. 2005;51:808–12.CrossRefGoogle Scholar
- 11.Short BL, Williams L. ECMO specialist training manual. 3rd ed. Michigan: Extracorporeal Life Support Organization; 2010.Google Scholar