OBJECTIVE Examine changing neonatal respiratory extracorporeal membrane oxygenation (ECMO) practice trends and outcomes. STUDY DESIGN Retrospective cohort study comparing neonatal respiratory ECMO in the 1990 and 2010 decades (1994-1995 and 2014-2015). Patients ≤ 30 days of life, reported to the Extracorporeal Life Support Organization registry, were included. RESULTS Four thousand one hundred and twenty-five patients met inclusion criteria. ECMO cases decreased by 33%. The primary ECMO diagnosis changed significantly over time (p < 0.0001). Survival to discharge decreased (76 vs 67%, p < 0.0001) and ECMO duration increased (131 vs 158 h, p < 0.001). Lung recovery was the most common reason to discontinue ECMO although family request for withdrawal and a diagnosis considered "incompatible with life" was increasingly common in the 2010s. CONCLUSION Although the use of ECMO for neonatal respiratory diagnoses has decreased over time, its use has increased for patients with more complex diagnoses and ECMO duration is longer. ECMO continues to be an important supportive therapy, improved understanding of which patients would benefit most is needed.

中文翻译：

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新生儿呼吸道体外膜氧合和初步诊断：两十年之间的趋势。

目的检查变化的新生儿呼吸体外膜氧合作用（ECMO）的实践趋势和结果。研究设计回顾性队列研究比较了1990年和2010年（1994-1995年和2014-2015年）的新生儿呼吸ECMO。包括≤30天生命的患者，这些患者已报告到体外生命支持组织注册表中。结果共有145名患者符合入选标准。ECMO案件减少了33％。ECMO的主要诊断随时间发生了显着变化（p <0.0001）。出院生存期减少（76％vs 67％，p <0.0001），ECMO持续时间增加（131 vs 158 h，p <0.001）。肺恢复是终止ECMO的最常见原因，尽管家庭要求撤离并被诊断为“与生命不相容” 在2010年代变得越来越普遍。结论尽管随着时间的流逝，ECMO在新生儿呼吸系统诊断中的使用有所减少，但对于诊断更复杂的患者，ECMO的使用却有所增加，并且ECMO持续时间更长。ECMO仍然是重要的支持疗法，需要更好地了解哪些患者将受益最大。