{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:20:35Z","timestamp":1787239235678,"version":"build-2736575974"},"reference-count":7,"publisher":"American Academy of Pediatrics (AAP)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background.<\/jats:title>\n                    <jats:p>Extracorporeal membrane oxygenation (ECMO) is an important treatment tool in the management of near-term and term neonates with severe hypoxemic respiratory failure. To better understand how health care for patients treated with ECMO has changed, we studied the demographic and treatment data reported to the Extracorporeal Life Support Organization (ELSO) registry from January 1, 1988, through January 1, 1998.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>We used data stored in the ELSO registry and evaluated the changes in demographics, use of alternate therapies before ECMO, severity of illness, duration of ECMO therapy, and mortality over a 10-year period. All data on neonates reported between January 1, 1988, and January 1, 1998 were used. Verification checks were performed on all fields to eliminate nonsense outliers. We separated the neonates into 2 groups\u2014those with and those without a congenital diaphragmatic hernia (CDH). All analyses were performed on the total group and each subgroup separately. Changes in continuous data were analyzed by year using analysis of variance. Year differences in categorical data were evaluated with \u03c72 analysis. We also used the linear trend test and the Cochran-Armitage trend test to evaluate time-related changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>We reviewed 12\u2009175 neonates. Over the decade, there were no changes in mean gestational age, gender, age at which ECMO was started, pH, or Paco2 just before ECMO. The proportion of neonates with CDH increased from 18% to 26%, while the proportion with respiratory distress syndrome decreased from 15% to 4%. Other diagnostic categories remained constant. The use of surfactant, high-frequency ventilation, and inhaled nitric oxide increased from 0% in 1988 to 36%, 46%, and 24%, respectively, in 1997. The mean peak pressure being used just before ECMO decreased (47 \u00b1 10 in 1988 to 39 \u00b1 12 in 1997), and the mean Pao2\/Fio2 ratio increased (38 \u00b1 23 in 1988 to 48 \u00b1 36 in 1997). The primary mode of ECMO remains venoarterial; however, the use of venovenous ECMO increased from 1% to 32% over the decade. Duration of ECMO treatment increased overall, and this trend was seen for patients with and without CDH (124 \u00b1 67 to 141 \u00b1 104 hours for the non-CDH group, 161 \u00b1 99 to 238 \u00b1 141 hours for the CDH group). The number of centers reporting neonatal data to the ELSO registry increased from 52 in 1988 to a peak of 100 in 1993. In 1997, 96 centers reported data to ELSO. The average number of neonatal patients reported from each site decreased from a peak of 18 in 1991 to 9 in 1997. Mortality increased from 18% to 22%; however, when corrected for the relative increase in neonates with CDH, this trend disappeared. Diagnoses-specific mortality rates remained constant. The occurrence of intracranial hemorrhage and\/or infarct also stayed constant at 16%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions.<\/jats:title>\n                    <jats:p>The population of neonates treated with ECMO in 1997 was very different from patients treated in the 1980s and early 1990s. They were exposed to an ever-expanding group of new therapies, appeared to be healthier based on indices of gas exchange, and were cared for at centers that reported fewer cases per year.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.106.6.1334","type":"journal-article","created":{"date-parts":[[2004,8,13]],"date-time":"2004-08-13T19:50:41Z","timestamp":1092426641000},"page":"1334-1338","source":"Crossref","is-referenced-by-count":102,"title":["The Changing Demographics of Neonatal Extracorporeal Membrane Oxygenation Patients Reported to the Extracorporeal Life Support Organization (ELSO) Registry"],"prefix":"10.1542","volume":"106","author":[{"given":"Beverly Jane","family":"Roy","sequence":"first","affiliation":[{"name":"From Emory University, Department of Pediatrics, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rycus","sequence":"additional","affiliation":[{"name":"University of Michigan, Ann Arbor, Michigan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Conrad","sequence":"additional","affiliation":[{"name":"Louisiana State University, Shreveport, Louisiana; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reese H.","family":"Clark","sequence":"additional","affiliation":[{"name":"Pediatrix Medical Group, Inc, Sunrise, Florida."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Extracorporeal Life Support Organization (ELSO) Registry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2000,12,1]]},"reference":[{"key":"2021121003330532700_B1","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1016\/0011-3840(90)90015-W","article-title":"Extracorporeal life support for cardiopulmonary failure.","volume":"27","author":"Bartlett","year":"1990","journal-title":"Curr Probl Surg."},{"key":"2021121003330532700_B2","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/S0140-6736(96)04100-1","article-title":"UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation.","volume":"348","author":"The UK Collaborative ECMO Trial Group","year":"1996","journal-title":"Lancet."},{"key":"2021121003330532700_B3"},{"key":"2021121003330532700_B4","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/S0022-3476(05)83501-2","article-title":"Efficacy of venovenous extracorporeal membrane oxygenation for neonates with respiratory and circulatory compromise.","volume":"122","author":"Cornish","year":"1993","journal-title":"J Pediatr."},{"key":"2021121003330532700_B5","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1542\/peds.84.6.957","article-title":"Extracorporeal membrane oxygenation and conventional medical therapy in neonates with persistent pulmonary hypertension of the newborn: a prospective randomized study.","volume":"84","author":"O'Rourke","year":"1989","journal-title":"Pediatrics."},{"key":"2021121003330532700_B6","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/S0022-3476(94)70354-X","article-title":"A decade of experience with neonatal extracorporeal membrane oxygenation.","volume":"124","author":"Kanto","year":"1994","journal-title":"J Pediatr."},{"key":"2021121003330532700_B7","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1016\/S0022-3468(96)90099-8","article-title":"ECMO in evolution: the impact of changing patient demographics and alternative therapies on ECMO.","volume":"31","author":"Wilson","year":"1996","journal-title":"J Pediatr Surg."}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/1334\/893028\/1334.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/106\/6\/1334\/893028\/1334.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T05:23:19Z","timestamp":1639113799000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/106\/6\/1334\/63240\/The-Changing-Demographics-of-Neonatal"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12,1]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2000,12,1]]},"published-print":{"date-parts":[[2000,12,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.106.6.1334","relation":{},"ISSN":["1098-4275","0031-4005"],"issn-type":[{"value":"1098-4275","type":"electronic"},{"value":"0031-4005","type":"print"}],"subject":[],"published":{"date-parts":[[2000,12,1]]}}}