Which value of the oxygenation index indicates the need for ECMO in a newborn?

The oxygenation index (OI) is a critical measurement used in neonatal care to assess the severity of respiratory failure and the need for advanced respiratory support, such as extracorporeal membrane oxygenation (ECMO). The OI is calculated using the formula: OI = (Mean Airway Pressure × FiO2 × 100) ÷ PaO2.

A value of 44 for the oxygenation index indicates significant hypoxemia and impaired oxygenation in the newborn. Generally, an OI of greater than 40-50 is often considered a threshold for initiating ECMO, as it suggests that the neonate is experiencing severe respiratory distress that is unresponsive to conventional therapies.

In clinical practice, values above 40 typically warrant close consideration for ECMO evaluation, as they indicate that the risk of death or significant morbidity is elevated due to inadequate oxygenation. Therefore, the oxygenation index of 44 effectively meets the criteria necessitating ECMO intervention, making it the appropriate choice in this scenario.