Extracorporeal Membrane Oxygenation (ECMO) for Newborn Persistent Fetal Circulation

A full-term newborn girl with severe hypoxia and cyanosis was treated with venoarterial cardiopulmonary bypass with a membrane oxygenator (ECMO) for life-support. Angiograms demonstrated minimal pulmonary blood flow, a large main pulmonary artery, and a patent ductus arteriosus with a total right-to-left shunt. The ductus was ligated on ECMO and support continued. Pulmonary function gradually changed from minimal gas exchange, high pulmonary vascular resistance to adequate gas exchange, low pulmonary vascular resistance. At seven days of life, the baby was weaned off ECMO and at nine days of life off mechanical ventilation. This is the first successful case of prolonged total cardiopulmonary support in a newborn. It demonstrates the effectiveness and safety of ECMO and the reversibility of persistent fetal circulation syndrome.