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Pediatric ECLS

Shannon B Spencer, Shigang Wang, Karl Woitas, Kristen Glass, Allen R Kunselman, Akif Ündar
The objective of this study was to evaluate an alternative neonatal extracorporeal life support (ECLS) circuit with a RotaFlow centrifugal pump and Better-Bladder (BB) for hemodynamic performance and gaseous microemboli (GME) capture in a simulated neonatal ECLS system. The circuit consisted of a Maquet RotaFlow centrifugal pump, a Quadrox-iD Pediatric diffusion membrane oxygenator, 8 Fr arterial cannula, and 10 Fr venous cannula. A "Y" connector was inserted into the venous line to allow for comparison between BB and no BB...
October 13, 2016: Artificial Organs
Jennifer Andrews, Anne M Winkler
For the past four decades, extracorporeal life support (ECLS) has been used to treat critically ill adult and pediatric patients with cardiac and/or respiratory failure, and there are increasingly numbers of centers worldwide performing ECLS for numerous indications. Despite the progress with advancing the technology, hemorrhagic and thrombotic complications are frequently reported and associated with worse outcomes, but the exact cause is often elusive or multifactorial. As a result of the interaction between blood and an artificial circuit, anticoagulation is necessary and there is resultant activation of coagulation, fibrinolysis, as well as, an increased inflammatory response...
October 2016: Transfusion Medicine Reviews
Lindsay M Ryerson, Laurence L Lequier
Anticoagulation is an imperfect science and is even more complicated in neonates and young children. The addition of the extracorporeal life support (ECLS) foreign circuit adds an additional layer of complexity. Anticoagulation goals during ECLS are to maintain a clot-free circuit and a hemostatically balanced patient. Unfractionated heparin (UFH) is the default gold standard anticoagulant as no large studies have been performed on any other anticoagulants. This review will focus on the advantages and disadvantages of the various methods to monitor UFH anticoagulation, discuss alternative anticoagulants, and examine bleeding and thrombotic complications during ECLS...
2016: Frontiers in Pediatrics
Alison B Nair, Peter Oishi
There is new and growing experience with venovenous extracorporeal life support (VV ECLS) for neonatal and pediatric patients with single-ventricle physiology and acute respiratory distress syndrome (ARDS). Outcomes in this population have been defined but could be improved; survival rates in single-ventricle patients on VV ECLS for respiratory failure are slightly higher than those in single-ventricle patients on venoarterial ECLS for cardiac failure (48 vs. 32-43%), but are lower than in patients with biventricular anatomy (58-74%)...
2016: Frontiers in Pediatrics
Erkut Öztürk, Okan Yıldız, Nihat Çine, Behzat Tüzün, Selen Onan, Yakup Ergül, Alper Güzeltaş, Sertaç Haydin, Mehmet Yeniterzi, İhsan Bakır
AIM: The aim of the study is to evaluate extracorporeal life support system (ECLS) employed in neonates in pediatric cardiac intensive care unit. MATERIAL AND METHODS: Twenty-five neonates that required ECLS in between November 2010 and November 2015 were evaluated. RESULTS: The median age was 12 days (range 3-28 days) and the median body weight was 3 kg (range 2.5-5 kg). Venoarterial ECLS was performed in all of the cases. Ascendan aorta-right atrial cannulation in 22 patients and neck cannulation in three patients were performed...
August 10, 2016: Journal of Maternal-fetal & Neonatal Medicine
Katherine W Gonzalez, Brian G A Dalton, Katrina L Weaver, Ashley K Sherman, Shawn D St Peter, Charles L Snyder
PURPOSE: Literature reports worse outcomes for operations performed during off-hours. As this has not been studied in pediatric extracorporeal life support (ECLS), we compared complications based on the timing of cannulation.. METHODS: This is a retrospective review of 176 pediatric ECLS patients between 2004 and 2015. Patients cannulated during daytime hours (7:00 A.M. to 7:00 P.M., M-F) were compared to off-hours (nighttime or weekend) using t-test and Chi-square...
July 2016: Pediatric Surgery International
Marlene Speth, Frank Münch, Ariawan Purbojo, Martin Glöckler, Okan Toka, Robert A Cesnjevar, André Rüffer
This study reports a single-centre experience of the Medos Deltastream diagonal-pump (DP3) for extracorporeal cardiac, pulmonary, or combined support in a single-center pediatric cohort. Twenty-seven consecutive patients with 28 runs of the DP3 between January 2013 and June 2014 were included for analysis. Median patient age, weight, and duration of support were 278 days (range: 0 days-14.2 years), 7.2 kg (range: 2.5-39 kg), and 8 days (range: 2-69 days). Midline sternotomy (n = 20, 71.4%) or cervical approaches (n = 8, 28...
July 2016: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Christopher R Burke, Titus Chan, Thomas V Brogan, Laurance Lequier, Ravi R Thiagarajan, Peter T Rycus, D Michael McMullan
AIM: Unintentional drowning is a significant public health concern in the United States and represents a leading cause of death in the pediatric population. Extracorporeal life support (ECLS) may be used to support drowning victims, but outcomes have not been well defined. This study examined survival rates and risk factors for death in this population. METHODS: Retrospective data from the Extracorporeal Life Support Organization registry was examined to determine outcomes of ECLS and risk factors for death in drowning victims...
July 2016: Resuscitation
Heather K Chandler, Beatriz Teppa, Khaliah A Johnson, Courtney McCracken, James D Fortenberry, Matthew L Paden
PURPOSE: The purpose of this study is to describe health-related quality of life (HRQoL) and the prevalence of comorbidities in pediatric survivors of extracorporeal life support (ECLS) and to determine risk factors for poor HRQoL. MATERIALS: The study design was a retrospective cohort and prospective follow-up study of patients who received ECLS in the pediatric intensive care unit at Egleston Children's Hospital from 2006 to 2013. Quality of life was measured using the Pediatric Quality of Life Inventory (PedsQL 4...
October 2015: Journal of Critical Care
Jacob Simmonds, Troy Dominguez, Joanna Longman, Nitin Shastri, Maura O'Callaghan, Aparna Hoskote, Matthew Fenton, Michael Burch, Victor Tsang, Kate Brown
BACKGROUND: Extracorporeal life support (ECLS) has proven success after conventional cardiac surgery. Its use after pediatric heart transplantation is less well documented. We reviewed ECLS after pediatric heart transplantation, to understand better predisposing factors, morbidity, and mortality. METHODS: The notes of all patients at Great Ormond Street Hospital undergoing orthotopic heart transplantation from 1999 to 2009 were reviewed (202 transplants; patients aged 0...
June 2015: Annals of Thoracic Surgery
Carlos Sanchez-Glanville, Mary E Brindle, Tanya Spence, Jaime Blackwood, Tanya Drews, Steve Menzies, Steven R Lopushinsky
BACKGROUND: Extracorporeal life support (ECLS) is a life-saving technology for the critically ill child. Our objective was to evaluate the outcomes of an educational curriculum designed to introduce an ECLS program to a noncardiac pediatric surgical center. METHODS: An interdisciplinary curriculum was developed consisting of didactic courses, animal labs, simulations, and debrief sessions. We reviewed all patients requiring ECLS between October 2011 and December 2013...
May 2015: Journal of Pediatric Surgery
İsmihan Selen Onan, Sertaç Haydin, Akif Ündar, M Nilüfer Yalındağ-Öztürk, Demet Demirkol, Gökhan Kalkan, Hakan Ceyran, Yüksel Atay, Ahmet Şaşmazel, Ali Rıza Karacı, Esra Şevketoğlu, Tolga Köroğlu, Hüsnü Fırat Altın, Pınar Yazıcı, Dinçer Yıldızdaş, Ali Ekber Çicek, Ender Ödemiş, Atıf Akçevin, İhsan Bakır
No abstract text is available yet for this article.
January 2015: Artificial Organs
Ashley Wendell Kranjac
Increased body weight is associated with decreased cognitive function in school-aged children. The role of self-efficacy in shaping the connection between children's educational achievement and obesity-related comorbidities has not been examined to date. Evidence of the predictive ability of self-efficacy in children is demonstrated in cognitive tasks, including math achievement scores. This study examined the relationship between self-efficacy and math achievement in normal weight, overweight, and obese children...
March 2015: Social Science & Medicine
Thomas J Desmarais, Yan Yan, Martin S Keller, Adam M Vogel
PURPOSE: The purpose of this study was to characterize enteral (EN) nutrition practices in neonatal and pediatric patients receiving extracorporeal life support (ECLS). METHODS: A Web-based survey was administered to program directors and coordinators of Extracorporeal Life Support Organization centers providing neonatal and pediatric ECLS. The survey assessed patient and clinical factors relating to the administration of EN. RESULTS: A total of 122 responses (122/521, 23...
January 2015: Journal of Pediatric Surgery
Yasuo Miyazaki, Maria Stack
The childhood obesity epidemic continues to be a serious concern in the U.S., disproportionately affecting low socioeconomic and minority groups. Because many interventions are based in schools, both individual and school factors contributing to obesity were examined in this study. Employing data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 (ECLS-K), a three level hierarchical linear model was used to estimate children's body mass index (BMI) growth trajectories within their school contexts...
March 2015: Social Science & Medicine
Lindsay M Ryerson, Gonzalo Garcia Guerra, Ari R Joffe, Charlene M T Robertson, Gwen Y Alton, Irina A Dinu, Don Granoski, Ivan M Rebeyka, David B Ross, Laurance Lequier
BACKGROUND: Survival after pediatric cardiac extracorporeal life support (ECLS) is guarded, and neurological morbidity varies widely. Our objective is to report our 10-year experience with cardiac ECLS, including survival and kindergarten entry neurocognitive outcomes; to identify predictors of mortality or adverse neurocognitive outcomes; and to compare 2 eras, before and after 2005. METHODS AND RESULTS: From 2000 to 2009, 98 children had venoarterial cardiac ECLS...
March 2015: Circulation. Heart Failure
Cordelie E Witt, Andrew L Mesher, Joshua L Hermsen, Thomas V Brogan, David Michael McMullan
Pediatric patients who require extracorporeal life support (ECLS) for refractory cardiorespiratory failure are at increased risk for intrapleural hemorrhage due to the effects of systemic anticoagulation and frequent occurrence of pneumothorax. Surgical evacuation is standard therapy for retained hemothorax to prevent secondary empyema, pulmonary compression, and development of fibrothorax. However, surgical interventions during ECLS are hazardous and place patients at increased risk for surgical site bleeding...
January 2015: World Journal for Pediatric & Congenital Heart Surgery
Arvin Garg, Sarah Toy, Yorghos Tripodis, John Cook, Nick Cordella
OBJECTIVE: To examine whether maternal depression predicts future household food insecurity for low-income families. METHODS: This was a secondary data analysis using data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B). The study cohort consisted of 2917 low-income mothers, defined as <185% federal poverty level, who were food secure at baseline. Maternal data collected when children were 9 and 24 months of age were used. Data at 9 months were considered baseline, and data at 24 months were considered follow-up...
May 2015: Academic Pediatrics
Young Jo
This paper investigates the relationship between family income and childhood obesity. Using the Early Childhood Longitudinal Study, Kindergarten Class of 1998-99 (ECLS-K), I report three new findings. First, family income and childhood obesity are generally negatively correlated, but for children in very low-income families, they are positively correlated. Second, the negative association between family income and Body Mass Index (BMI) is especially strong and significant among high-BMI children. Third, the difference in obesity rates between children from low- and high-income families increases as children age...
December 2014: Economics and Human Biology
A Zilanawala, P Davis-Kean, J Nazroo, A Sacker, S Simonton, Y Kelly
OBJECTIVE: Racial/ethnic patterning in the risk of obesity and overweight has been observed in early childhood; however, little research has compared these disparities between the United Kingdom (UK) and United States (US) using detailed ethnic classifications. We use comparable nationally representative cohort studies to examine racial/ethnic disparities in mean body mass index (BMI) and in the odds of obesity/overweight in the UK and US. The contribution of sociodemographic, cultural and family routine factors are assessed...
March 2015: International Journal of Obesity: Journal of the International Association for the Study of Obesity
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