Extracorporeal membrane oxygenation (ECMO, or extracorporeal life support) uses a constellation of biomedical devices that reproduce the functions of the heart and lungs. This technology provides sustained life support for selected newborn and pediatric patients; these children are often suffering from overwhelming respiratory or cardiac failure which has proved refractory to other treatments. For newborns, the therapy is not unlike returning the infant to his mother's placenta, for a more gradual transition to breathing air.

Since 1982, the Center for Extracorporeal Life Support at Babies and Children's Hospital has been directed by Dr. Charles Stolar in the Division of Pediatric Surgery. The Center was the third in the world to successfully support a neonate. More than 2,500 infants have been referred as potential ECMO patients from 47 institutions throughout the Tri-State area and the Mid-Atlantic region. To date, 175 infants and a smaller number of older children have been treated with ECMO, of whom 84% are at home with their parents.

However, ECMO is only part of the respiratory care strategy in the Neonatal Intensive Care Unit, which is itself a unique resource. Respiratory failure is the most common cause of death and complications in the newborn. The Neonatal Intensive Care Unit at Babies Hospital has earned an international reputation for excellence in respiratory care, which rests on our results: the frequency of chronic lung disease in premature infants treated in our unit is the lowest in the United States. We have a particular interest in newborns with congenital diaphragmatic hernia. By designing a protocol focused on the gentle support of the fragile lungs of these babies, we have been able to turn a mortality rate of 50% into a survival rate of 92% for patients with this condition.