ECMO ECMO in Neonatal and Pediatric Populations

Question 1

What is the minimum gestational age generally accepted as a criterion for neonatal ECMO candidacy?

Accepted Answer

34 weeks

Answer

Most centers require ≥34 weeks gestational age because premature neonates face prohibitively high rates of intracranial hemorrhage on ECMO anticoagulation.

Question 2

What is the most common indication for ECMO in neonates in the United States?

Accepted Answer

Meconium aspiration syndrome (MAS)

Answer

Meconium aspiration syndrome causing severe respiratory failure and pulmonary hypertension is the most frequent neonatal ECMO indication in the US.

Question 3

Which ECMO configuration is most commonly used in neonates requiring support?

Accepted Answer

Veno-arterial (VA) ECMO via neck vessels

Answer

Neonatal VA-ECMO via the right internal jugular vein and right common carotid artery provides both cardiac and respiratory support through accessible neck vessels.

Question 4

The oxygenation index (OI) threshold commonly used to consider ECMO in neonates is:

Accepted Answer

>40

Answer

An OI >40 (calculated as MAP × FiO2 × 100 / PaO2) on two or more blood gases indicates severe respiratory failure warranting ECMO consideration.

Question 5

What minimum body weight is typically required for neonatal ECMO candidacy at most US centers?

Accepted Answer

2.0 kg

Answer

A weight of at least 2.0 kg is the typical threshold because smaller neonates have vessels too small to cannulate safely without causing severe ischemia.

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO - Extracorporeal Membrane Oxygenation Practice Test

ECMO ECMO in Neonatal and Pediatric Populations