The number of centers providing extracorporeal membrane oxygenation (ECMO) therapy to newborns with intractable respiratory failure has grown dramatically. The ECMO registry now includes 37 institutions in the United States,1 and there may be additional centers offering ECMO but not participating in the registry. To date, more than 1,400 patients have been treated with ECMO with a survival rate exceeding 80%. Widespread acceptance of ECMO therapy has been accomplished despite a paucity of controlled clinical trials2 and without the benefit of long-term follow-up of survivors. Initial fervor about neonatal ECMO has stemmed from the excellent survival statistics cited by most of the earlier investigators.2-4