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Neonatal care
YNHH

For Referring Physicians

Frequently Asked Questions of Referring Physicians:

Is my patient eligible for ECMO?

Eligibility Criteria

  • Gestational age> 34 weeks and weight > 2 kg
  • No major intracranial hemorrhage
  • No evidence of severe neurological impairment
  • Reversible lung disease with length of mechanical ventilation for < 7-10 days. Note: Patients who have been mechanically ventilated for > 10 days would be considered for ECMO on a case-by-case basis.
  • No uncorrectable congenital heart disease in a patient who is not a transplant candidate
  • No lethal congenital malformations
  • Failure of optimal medical management
  • No evidence of severe hemorrhage or uncorrectable coagulopathy
  • No severe immunosuppression
  • No irreversible condition considered to be terminal

Are there any criteria that I can use to help me determine when transfer for ECMO should be considered for my patient?

  • Oxygenation Index (OI) 25-30 (ECMO is typically initiated at OI > 40)
    • Oxygenation Index = MAP x FiO2 x 100 / PaO2
    • MAP - mean airway pressure
    • FiO2 - % oxygen expressed as a decimal
    • PaO2 - partial pressure of O2
  • PaO2s 40-60 torr despite escalation of ventilatory support
  • When considering the use of inhaled nitric oxide or high frequency ventilation, if available at your institution

How do I transfer my patient to Yale-New Haven Children's Hospital for ECMO?

Please contact Y Access, our 24 hour/day transfer hotline at 888.964.4233 (888-YNHH-BED) and request either a neonatal or pediatric transport.

Is there anyone I can speak to about my patient even if I have not yet decided to transfer him/her to Yale-New Haven?

ECMO-trained neonatal and pediatric critical care attending physicians are available 24 hours a day for consultation via the Y-access hotline (888.964.4233), and we welcome ANY and ALL inquiries.

If the decision is made to transfer a patient, our neonatal and pediatric critical care transport teams will work closely with you to ensure that the infant/child is able to be moved safely.

For questions of a non-urgent nature regarding our ECMO services, please contact Matthew Bizzarro, MD in the Newborn Intensive Care Unit office at 203.688.2320 or via email at matthew.bizzarro@yale.edu or John Giuliano, MD in the Pediatric Intensive Care Unit office at 203.785.4651 or via email at john.giuliano@yale.edu.

If I transfer my patient to Yale-New Haven Children's Hospital, will he/she be transferred back to my institution?

We will provide timely updates and once stabilized, we will make every effort to transfer the patient back to your facility for ongoing care.

For more information about Extracorporeal Life Support Organization (ELSO) recommendations for followup for ECMO patients, click here.



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