For Referring Physicians

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

• 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

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.

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.

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