While extracorporeal membrane oxygenation (ECMO) can be used to manage neonates with cardiac or respiratory failure, it should only be used in carefully selected patients. It should not be used in the presence of one or more contraindications.

Contraindications to ECMO in Neonates


body weight < 2 kilograms

small blood vessels make cannulation difficult and requires tubing with high resistance due to narrow gauge

gestational age < 34 weeks

prematurity associated with multiple under-developed organ systems

intraventricular hemorrhage (IVH) Grade > 1

risk of IVH increased with ECMO; grading discussed in 17.06.02

irreversible injury to brain, heart, liver and/or kidney


respiratory failure not reversible in 10-14 days


mechanical ventilation for > 7-10 days


overwhelming sepsis


severe coagulopathy


parental refusal



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