Neonatal extracorporeal life support: Impact of new therapies on survival

Paola J. Fliman*, Raye Ann O. deRegnier, John P. Kinsella, Marleta Reynolds, Linda L. Rankin, Robin H. Steinhorn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Scopus citations


Objective: To evaluate the effects of pre-extracorporeal life support (ECLS) management with nitric oxide (NO), high frequency ventilation (HFV), and surfactant on mortality among neonates supported with ECLS. Study design: Extracorporeal Life Support Organization (ELSO) data on 7017 neonates cannulated for respiratory reasons between 1996 and 2003 were analyzed using χ2, analysis of variance, and logistic regression. Results: The use of ECLS declined by 26.6% over the study period with no significant change in mortality. Unadjusted ECLS mortality for NO-treated patients was lower than for infants not treated with NO (25.1% vs 28.6%, P = .0012) and for infants treated with surfactant than for infants not treated with surfactant (18.7% vs 30.3%, p <.0001.) Unadjusted mortality for HFV-treated patients was no different than for non-HFV-treated patients (26.0% vs 26.6%, P = .56). After adjusting for confounders (primary diagnosis, age at cannulation, ECMO year 1996-1999 vs 2000-2003), surfactant use was associated with decreased mortality. NO-treated neonates were less likely to have a pre-ECLS cardiopulmonary arrest than infants not treated with NO. NO, HFV, and surfactant were not associated with prolongation of ECLS or mechanical ventilation. Conclusions: NO, HFV, and surfactant were not associated with increased mortality in neonates who require ECLS for hypoxic respiratory failure.

Original languageEnglish (US)
Pages (from-to)595-599
Number of pages5
JournalJournal of Pediatrics
Issue number5
StatePublished - May 2006

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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