Ecmo

Well, my first day of clinical was this week, and I loved every second of it. I'm looking for a little help and explanation on one of the cases. We were sent to NICU to put a munchkin on ECMO, but venous only. The only issue was horrible lungs, bad ABG's, PPHN- all from meconium aspiration. But it was bad enough to warrant ECMO to bypass the lungs. Baby was already on HFJV with nitric. Can anyone explain this to me a little bit better. No books have done a very good job. I'm not familiar with ECMO for little ones, and I'm hoping I relayed all of this correctly. I guess I'm just trying to figure out anatomically how this would work ( they used IJ and carotid I think), and also physiologic results. Pav and Fentanyl were the drugs of choice of my CRNA. Any thoughts on using any benzo for hypnotic? Does anyone out there go that route for neonates? This case was quite a doozy for the first as a SRNA. But, peds anesthesia is my goal, and this just reaffirmed that peds is the direction God is sending me in. Thanks for any help!