Extracorporeal Membrane Oxygenation (ECMO) for suspected neonatal genetic diagnoses with cardiorespiratory failure.

Authors

Kelechi Ikeri, Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA.
Vilmaris Quinones Cardona, Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA - Drexel University College of Medicine, Philadelphia, PA, USAFollow
Swosti Joshi, Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA - Drexel University College of Medicine, Philadelphia, PA, USAFollow
Ogechukwu Menkiti, Division of Neonatology, Department of Pediatrics, St. Christopher's Hospital for Children, Philadelphia, PA 19134, USA - Drexel University College of Medicine, Philadelphia, PA, USAFollow

Document Type

Article

Publication Date

9-2023

Abstract

Recent data describe an increasing use of extracorporeal membrane oxygenation (ECMO) in neonates with various clinical conditions besides primary respiratory or cardiac diagnoses. Infants with underlying genetic disorders characterized by cardiopulmonary failure pose unique management challenges. When pathognomonic dysmorphic features for common genetic diagnoses are not present, the prognosis is uncertain at best when determining ECMO candidacy. Lengthy turnaround times of genetic testing often delay definitive diagnosis during the ECMO course. Clinical management pathways to guide practice and evidence to support the use of ECMO in rare genetic conditions are lacking. The decision to initiate ECMO is daunting but may be of benefit if the subsequent genetic diagnosis is non-lethal. In lethal genetic cases warranting discontinuation of care, the time spent on ECMO may still be advantageous as a bridge to diagnosis while allowing for parental bonding with the terminally ill infant. Diagnostic confirmation may also facilitate the attainment of closure for these parents. Here, we report our experience providing ECMO to three neonates presenting with cardiorespiratory failure and later diagnosed with rare genetic syndromes. We share the challenges faced, lessons learned, and outcomes of these critically ill neonates.

Publication Title

The Journal of extra-corporeal technology

Volume

55

Issue

3

First Page

147

Last Page

152

Recommended Citation

Ikeri, K., Quinones Cardona, V., Joshi, S., & Menkiti, O. (2023). Extracorporeal Membrane Oxygenation (ECMO) for suspected neonatal genetic diagnoses with cardiorespiratory failure.. The Journal of extra-corporeal technology, 55 (3), 147-152. https://doi.org/https://doi.org/10.1051/ject/2023016