Awake extracorporeal membrane oxygenation in a neonatal patient with respiratory failure

Background: Awake extracorporeal membrane oxygenation (ECMO) in conscious, extubated patients has been used successfully in adults and children, primarily as a bridge to lung or heart–lung transplantation and recovery from refractory cardiogenic shock. 1,2 However, this strategy has been reported only as an exceptional measure in neonatal patients. We present a case of neonatal respiratory failure where an infant was extubated while on ECMO and managed without invasive ventilation. Methods: The clinical details, laboratory investigations, management, and outcome of the patient were reviewed from the electronic health record. This single-patient case report was exempt from the IRB at our institution. The photograph was used with parental consent. Results: The patient was a 2950 g product of an uncomplicated term pregnancy, whose postnatal course was complicated by neonatal acute respiratory failure, pulmonary hypertension, and bilateral pneumothoraces. The infant was managed on veno-arterial (VA) ECMO. Des...