Need for and impact on neonatal mortality of extracorporeal membrane oxygenation in infants of greater than 2500-gram birth weight

The use of extracorporeal membrane oxygenation (ECMO) has increased significantly during the last 4 years, with more than 2400 infants now having been treated with the technique. In spite of an ill-defined role for ECMO as well as the potential for neurologic sequelae for these patients, additional centers continue to be established across the United States. To provide information regarding the number of babies who could be expected to require ECMO, the early neonatal deaths for the state of Georgia were reviewed for the 2-year period 1983-1984. By means of both linked birth and death certificate analysis and chart review of infants with a birth weight of 2500 g or more, identification was made of 36 infants whom we classified as potential ECMO candidates. These infants were thought to represent 80% of all infants who would have received ECMO during the 2 years, resulting in an estimate of 1 patient receiving ECMO per 3717 live births for the state. With a predicted survival rate of 80% for this group, the state neonatal mortality rate would have declined by 0.13 per 1000 live births, a decrease of 1.4%.