New trends in extracorporeal membrane oxygenation in newborn pulmonary diseases.

New trends in extracorporeal membrane oxygenation (ECMO) for respiratory failure in the newborn were reviewed. Following a decade of clinical research, ECMO is now the standard treatment for newborn respiratory failure when all other conventional less-invasive treatment options have been exhausted. As of July 2000, 15,525 newborns with respiratory failure treated with ECMO have been entered into the registry of the Extracorporeal Life Support Organization with an overall survival rate of 78%. The latest improvement in ECMO technology in this group of patients includes minimally invasive modes of vascular access through percutaneous approaches to minimize morbidity. However, with advances in modes of mechanical ventilation, including high-frequency ventilation and the introduction of inhaled nitric oxide, the use and necessity for ECMO have clearly diminished for newborn respiratory failure.