[VickyRN]

Just curious. The local teaching hospital does not use this. Duke University Medical Center is the nearest facility which does.

[Jennrog]

My son was on ECMO in San DIego 10 years ago.

Originally Posted by VickyRN

Just curious. The local teaching hospital does not use this. Duke University Medical Center is the nearest facility which does.

[TiffyRN]

The hospital I work at doesn't do it but the children's hospital across the street does (both of us are level III). There's some restriction on weight and gestational age isn't there?

[dawngloves]

We also send our kids to the local Children's Hospital for ECMO. It's usually our last resort for really bad PPHN kids. I think they have to be greater than 35 weeks and 2k because of the high doses of heparin needed. Hope someone can assist with guidlines.

[Gompers]

Originally Posted by dawngloves

We also send our kids to the local Children's Hospital for ECMO. It's usually our last resort for really bad PPHN kids. I think they have to be greater than 35 weeks and 2k because of the high doses of heparin needed. Hope someone can assist with guidlines.

We do the exact same thing, and those guidelines seem reasonable.

We probably only send 4-6 kids per year out for ECMO, and out of that maybe 3-4 actually end up needing it. We usually only send out the ones who don't respond to nitric oxide within a few hours. But luckily, most do so nitric has literally been a lifesaver!

[BittyBabyGrower]

Same here Gompers....I honestly can't remember the last kid we sent out for ECMO since we started Nitric!

I believe it is 35 weeks and greater, over 2 kilos, no active bleed in the head.

We used to send kids left and right year ago...across state lines at that as we didn't have an ECMO facility anywhere around here! We used to sit and bag those kids for hours on end waiting for a bed to open. We have one across town now. Nitric and better prenatal care/education has made a lot of changes!

[Jolie]

There is a great article on ECMO in the current issue of Neonatal Network. It describes the procedure in detail and discusses the decrease in its use with the availability of nitric oxide, surfactant, and better delivery room management of meconium aspiration.

[Litlbabynurse]

I just recently (this week) transferred from a major children's hospital to a smaller unit in the same healthcare network. While the unit I'm in now does not use ECMO (we transfer), the unit that I just left uses ECMO quite a bit.

It seems to run in waves. We could go for weeks without an ECMO patient, and then have three kids or more on circuits at the same time. The last night that I worked there, four babies were on it.

As far as the criteria, I'm not really sure about gestational age, but I've only seen one child under 2kg on it during the four years that I was there. We used it mostly for mec aspirations, diaphramatic hernia, hypoplastic left, and PPHN.

[kids]

Originally Posted by VickyRN

Just curious. The local teaching hospital does not use this. Duke University Medical Center is the nearest facility which does.

Totally off the subject...Ross Ungerleider (at Duke until 2-3 years ago) is one of the "gurus" of ECMO, he is my grandson's cardiothoracic surgeon