ABSTRACT
The success of medicine, and in particular neonatal care, has arisen from the drive to provide care that is evidence-based. It is generally accepted that the most appropriate way to evaluate new treatments is in the form of a randomised trial. Extra-corporeal Membrane Oxygenation (ECMO) is a form of lung-bypass. First developed in adult practice in the early 1980s it was introduced into neonatal practice in Europe in the late 1980s. Prior to the UK collaborative ECMO trial, any fully mature newborn infant with a specific lung condition in which gaseous exchange was a problem despite full support via a ventilator could be considered for ECMO. The clinical conditions were such that the majority of infants would have been expected to develop the condition leading to respiratory failure only in the first 24 hours after birth, i.e. they would not have been predicted prior to delivery.
