Which condition among the following is NOT a typical ECMO candidate in neonates?

• A. Barotrauma
• B. Cystic Fibrosis
• C. Congenital Diaphragmatic Hernia
• D. Severe PPHN

Answer: (B)

Neonatal ECMO is used when a newborn has life-threatening oxygenation or perfusion failure that is potentially reversible with time and lung rest. Classic candidates are conditions that cause acute, severe respiratory failure in the newborn but can improve with support or after a corrective intervention. Congenital diaphragmatic hernia and severe PPHN fit this pattern because they create critical gas exchange problems in the short term, and ECMO can bridge the baby to recovery or surgical correction. Barotrauma reflects a vent-related complication indicating significant lung injury; it signals severity and may prompt consideration of ECMO to allow the lungs to rest, but it is not a disease process itself and not a primary indication. Cystic fibrosis, on the other hand, is a chronic genetic lung disease that typically presents after the neonatal period and progresses over time; it does not represent an acute, reversible newborn crisis, so it is not a typical neonatal ECMO candidate.