Perfusion
. 2025 Dec 22:2676591251409381.
doi: 10.1177/02676591251409381. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/41424306/
Neonatal ECMO outcomes in transported versus in-house patients: A single-center study
Eitan Keizman 1 2 3, Evyatar Hubara 3 4, Tal Sadeh 3 4, Yelena Skourikhin 3 4, Marina Rubinshtein 3 4, Guy Dumanis 5, Itai M Pessach 3 4, David Mishaly 2 3, Uri Pollak 6 7, Reut Kassif Lerner 3 4
Affiliations Expand
- PMID: 41424306
- DOI: 10.1177/02676591251409381
Abstract
BackgroundExtracorporeal membrane oxygenation (ECMO) is a life-saving intervention for neonates with severe respiratory or circulatory failure. Due to its complexity, ECMO is often performed in specialized centers, necessitating the transport of eligible patients from non-ECMO centers. While ECMO transport has been deemed safe, limited data exist comparing outcomes between in-house and transported neonates. This study aimed to evaluate the survival and long-term outcomes of neonates requiring ECMO support based on the cannulation location.MethodsA single-center study was conducted at the largest tertiary center in Israel (2009-2025). Patients were categorized based on cannulation site: in-house ECMO (performed at the tertiary center) or on-site ECMO (cannulated at the referring center and transported on ECMO support). Primary endpoints were in-hospital and long-term survival. Secondary outcomes included ECMO-related complications and long-term sequelae.ResultsA total of 53 neonates received ECMO support, with 26 (49.1%) in the in-house group and 27 (50.9%) in the on-site group. Despite pre-cannulation differences, including higher vasoactive-inotropic scores in the in-house group, lower pH and higher pCO2 in the on-site group, there were no statistically significant differences between the groups (53.8% vs 77.8%, p = 0.12). ECMO-related adverse events and long-term sequelae showed no statistically significant differences between groups, though the study was underpowered to detect clinically meaningful differences.ConclusionAlthough survival rates of critically ill neonates requiring on-site ECMO initiation and transport and those connected to ECMO in the in-house setting, did not differ significantly, the study was underpowered to detect potentially meaningful differences. Nonetheless, the findings reinforce the viability of neonatal ECMO transport.
Keywords: ECMO; congenital diaphragmatic hernia; meconium aspiration syndrome; transport.
About The Author
