Since the initiation of Extracorporeal Life Support Organization (ELSO) Registry in 1989, more than 47,000 neonates treated with extracorporeal membrane oxygenation (ECMO) have been registered worldwide with an overall survival rate of 65% to transfer or hospital discharge [1]. A brief overview of the last 5-year ELSO Registry data reveals an important shift in the indication for neonatal ECMO (Fig. 1A and B) with a notable increase in neonatal cardiac ECMO (44%–52%, respectively) [1].

This shift in indication for neonatal ECMO from pulmonary to cardiac failure may have important implications for long-term outcomes, particularly as neonates with congenital heart disease (CHD) may have other important genetic or acquired morbidities that may influence medical and neurodevelopmental follow-up [2,3]. With increasing familiarity and cumulative experience with ECMO, neonates with complex co-morbidities and refractory cardiopulmonary resuscitation who previously would not have qualified, are being referred and supported on ECMO. Thus, an increasing number of ECMO recipients will need long-term follow-up, and the follow-up programs for neonatal ECMO survivors will need to address the impact of the underlying disease and pre-ECMO clinical state in addition to the on ECMO and post ECMO risk factors