Abstract
Background
Bronchiolitis is the most common lower respiratory tract infection in infants under 1 year of age. Although outcomes are generally good in neonates, preterm infants may experience rapid clinical deterioration and require extracorporeal membrane oxygenation (ECMO) as a rescue therapy.
Objective
To describe the characteristics and clinical outcomes of neonates requiring ECMO for acute bronchiolitis over the past decade.
Methods
An observational, retrospective, single-center study conducted in a level IIIC neonatal unit. All neonates admitted between 2013 and 2022 who required ECMO for bronchiolitis-related respiratory failure were included. Demographic, clinical, and outcome variables were analyzed.
Results
Six patients were included: five (83%) were preterm, with a median gestational age of 28.6 weeks (IQR 27.1–29.6). Respiratory syncytial virus was isolated in four patients, rhinovirus in one and influenza A in one. At ECMO initiation, median age was 48.5 days (IQR 34–120), median postmenstrual age was 38 weeks (IQR 35–41.8), and median weight was 2490 g (IQR 1800–2900). The median duration of ECMO was 14 days (IQR 9–24). Two patients (33%) died, both preterm with RSV infection. All survivors were followed up by pediatric pulmonologists and neurologists. Two required home oxygen, and three showed neurodevelopmental disorders.
Conclusion
In our cohort, the two non-survivors were preterm, RSV positive, and required prolonged ECMO support. Among survivors, respiratory and neurodevelopmental complications were common, underscoring the need for structured long-term follow-up. Neurodevelopmental impairment was the most frequent sequela observed.
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