Citation Information :
Gowda SH, King A, Vogel AM, Coleman RD, Chartan CA, Garcia-Prats JA, Fernandes CJ. Real-time Echocardiography-guided Weaning of Veno-arterial Extracorporeal Membrane Oxygenation in Neonates. 2022; 1 (1):27-31.
Objective: The objective of the study is to evaluate the utility of real-time echocardiography (RTE) to provide objective hemodynamic guidance during decannulation of neonates from extracorporeal membrane oxygenation (ECMO).
Design: Retrospective case series.
Patients: Neonates with respiratory and circulatory failure who underwent venoarterial ECMO (VA-ECMO).
Interventions: Use of RTE to assess cardiac function, pulmonary hypertension (PH), and readiness for decannulation from ECMO.
Outcome measures: Data abstracted included clinical parameters, RTE data, and management decisions during weaning from VA-ECMO.
Results: We used RTE during weaning in 12 of 33 patients between 2016 and 2019. Findings prompted inotrope titration in 10 (83%) patients and volume resuscitation in 10 patients. PH was present in 12 (100%) patients and prompted initiation of prostaglandin infusion (in 3 (25%) patients. Ten of 12 patients were successfully weaned off; in 2, RTE was instrumental in halting decannulation.
Conclusions: RTE may serve as a valuable tool in clinical decision-making while weaning neonates from VA-ECMO and providing data to choose appropriate support for successful decannulation.
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