Successful Use of Extracorporeal Membrane Oxygenation in a Neonate With Arterial pH Less Than 6.6

Challenges in extracorporeal membrane oxygenation (ECMO) support include defining appropriate patient selection criteria and prognostic factors. Severe acidosis prior to ECMO deployment is often considered a relative contraindication and an independent predictor of mortality. We present a case of a term infant, with persistent pulmonary hypertension of the newborn with severe pre-ECMO acidosis (arterial blood pH 6.596) in whom venoarterial ECMO was instituted successfully without major circuit or patient-associated complications. At seven months of age, he exhibited age-appropriate neurodevelopmental milestones. We therefore report this instance of successful use of ECMO in the setting of extreme acidosis.