North American neonatal extracorporeal membrane oxygenation (ECMO) devices and team roles: 2008 survey results of Extracorporeal Life Support Organization (ELSO) centers.

In early 2008, surveys of active extracorporeal membrane oxygenation (ECMO) centers in North America were conducted by electronic mail regarding neonatal ECMO equipment and professional staff. Eighty of 103 (78%) North American ECMO centers listed in the Extracorporeal Life Support Organization directory as neonatal centers responded to the survey. Of the responding centers, 82.5% routinely used roller pumps for neonatal ECMO, and the remaining 17.5% used centrifugal pumps. Silicone membrane oxygenators were used by 67% of the respondents, whereas 19% used micro-porous hollow fiber oxygenators, and 14% used polymethylpentene hollow fiber oxygenators. Of the silicone membrane oxygenator users, 86% used the Medtronic Ecmotherm heat exchanger, 10% used the Gish HE-4 heat exchanger, and 4% used the Terumo Conducer device. Sixty-four percent of the responding centers used some form of in-line blood gas monitoring. Six percent of the centers used a bubble trap in the arterial line, and 5% used an arterial line filter. A bladder was used by 85% of the centers, and 4% of these used a mechanical bladder box for servo regulation; the remaining 96% used pressure servo regulation. An air bubble detector was used by 88% of the responding centers. A surface coating was used by 44% of the centers on all their neonatal ECMO patients. Thirty-one percent of the centers use an activated clotting time of 180-220 seconds. At 54% of the responding centers, perfusionists were involved with the ECMO program, registered nurses were involved at 70% of the centers, and respiratory therapists were involved at 46% of the centers. Compared with a 2002 survey, silicone membrane use is declining, and the use of centrifugal blood pumps and coated ECMO circuits is becoming more apparent. ECMO teams are still multidisciplinary, made up of combinations of registered nurses, respiratory therapists, and perfusionists.

[1]  D. S. Lawson,et al.  North American neonatal extracorporeal membrane oxygenation (ECMO) devices: 2002 survey results. , 2004, The journal of extra-corporeal technology.

[2]  J. Zwischenberger,et al.  Devices and monitoring during neonatal ECMO: su rvey results , 1990, Perfusion.

[3]  T. Scalea,et al.  Extracorporeal lung support in a patient with traumatic brain injury: the benefit of heparin-bonded circuitry , 1999, Perfusion.

[4]  D. W. Fried,et al.  CDI Blood Parameter Monitoring System 500--a new tool for the clinical perfusionist. , 2000, The journal of extra-corporeal technology.

[5]  Y. Tamari,et al.  An improved bladder for pump control during ECMO procedures. , 1999, The journal of extra-corporeal technology.

[6]  J. Zwischenberger,et al.  Anticoagulation practices during neonatal extracorporeal membrane oxygenation: survey results , 1996, Perfusion.

[7]  B. Searles,et al.  2004 survey of ECMO in the neonate after open heart surgery: circuitry and team roles. , 2005, The journal of extra-corporeal technology.

[8]  R. Eberhart,et al.  Acute respiratory insufficiency. Treatment with prolonged extracorporeal oxygenation. , 1972 .

[9]  K. V. van Meurs,et al.  ECMO for neonatal respiratory failure. , 2005, Seminars in perinatology.

[10]  M. Manfra,et al.  Update on pediatric perfusion practice in North America: 2005 survey. , 2005, The journal of extra-corporeal technology.

[11]  R. Odell,et al.  Identification and certification of extracorporeal membrane oxygenation specialists in the United States. , 1992, ASAIO journal.