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Pediatric ECLS

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https://www.readbyqxmd.com/read/29605581/hematological-complications-in-children-subjected-to-extracorporeal-membrane-oxygenation
#1
M J Santiago, C Gómez, I Magaña, V Muñoz, P Saiz, A Sánchez, J López-Herce
OBJECTIVES: To analyze the hematological complications and need for transfusions in children receiving extracorporeal life support (ECLS). DESIGN: A retrospective study was carried out. SETTING: A pediatric intensive care unit. PATIENTS: Children under 18 years of age treated with ECLS between September 2006 and November 2015. INTERVENTIONS: None. VARIABLES OF INTEREST: Patient and ECLS characteristics, anticoagulation, hematological and coagulation parameters, transfusions and clinical course...
March 29, 2018: Medicina Intensiva
https://www.readbyqxmd.com/read/29580960/prediction-of-survival-in-accidental-hypothermia-requiring-extracorporeal-life-support-an-individual-patient-data-meta-analysis
#2
Richard S Saczkowski, Doug J A Brown, Riyad B Abu-Laban, Guy Fradet, Costas J Schulze, Nick D Kuzak
BACKGROUND: Extra-corporeal life support (ECLS) is a life-saving intervention for patients with hypothermia induced cardiac arrest or severe cardiovascular instability. However, its application is highly variable due to a paucity of data in the literature to guide practice. Current guidelines and recommendations are based on expert opinion, single case reports, and small case series. Combining all of the published data in a patient-level analysis can provide a robust assessment of the influence of patient characteristics on survival with ECLS...
March 23, 2018: Resuscitation
https://www.readbyqxmd.com/read/29559752/anticoagulation-management-during-first-five-days-of-infant-pediatric-extracorporeal-life-support
#3
Kirk R Bingham, Jeffrey B Riley, Gregory J Schears
Anticoagulation during infant-pediatric extracorporeal life support (ECLS) has been a topic of study for many years, but management of anticoagulation is still only partially understood. Adequate anticoagulation during ECLS is imperative for successful outcomes and understanding the individual variables that play part is crucial for properly implementing anticoagulation management strategies. The purpose of our study was to compare the relationships between the variables of activated partial thromboplastin time (aPTT), activated clotting time, international normalized ratio, bleeding, thrombus formation, kaolin + heparinase thromboelastograph alpha angle, kaolin thromboelastograph reaction time (KTEG R-time), heparin dose rates (HDR), antithrombin (AT), anti-Xa, bivalirudin dose rate, argatroban dose rate, interventions, and transfusions...
March 2018: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/29538187/early-childhood-learning-and-the-pediatrician-a-qualitative-study-among-diverse-low-income-caregivers
#4
Jecca Rhea Steinberg, Janine S Bruce, Paloma Marin-Nevarez, Kimmy Phan, Sylvia Bereknyei Merrell, Lisa J Chamberlain
OBJECTIVE: School readiness by kindergarten entry is associated with increased high school graduation, decreased juvenile arrest, and better long-term health. Inadequate early childhood learning (ECL) disproportionately affects low-income children. Pediatricians have near-universal access to children younger than 5 years but remain an underused ECL resource. This study examined caregivers' perceptions of ECL, the role of the pediatrician and pediatric office, and the use of community-based ECL resources among diverse, low-income caregivers whose children were not enrolled in preschool...
March 13, 2018: Journal of Developmental and Behavioral Pediatrics: JDBP
https://www.readbyqxmd.com/read/29473652/in-vitro-evaluation-of-ecg-synchronized-pulsatile-flow-using-the-i-cor-diagonal-pump-in-neonatal-and-pediatric-ecls-systems
#5
Morgan Moroi, Madison Force, Shigang Wang, Allen R Kunselman, Akif Ündar
The objective was to assess the i-cor electrocardiogram-synchronized diagonal pump in terms of hemodynamic energy properties for off-label use in neonatal and pediatric extracorporeal life support (ECLS) circuits. The neonatal circuit consisted of an i-cor pump and console, a Medos Hilite 800 LT oxygenator, an 8Fr arterial cannula, a 10Fr venous cannula, 91 cm of 0.6-cm ID arterial tubing, and 91 cm of 0.6-cm ID venous tubing. The pediatric circuit was identical except it included a 12Fr arterial cannula, a 14Fr venous cannula, and a Medos Hilite 2400 LT oxygenator...
February 23, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29459043/is-there-a-best-approach-for-extracorporeal-life-support-cannulation-a-review-of-the-extracorporeal-life-support-organization
#6
Kevin Johnson, Marcus D Jarboe, George B Mychaliska, Ryan P Barbaro, Peter Rycus, Ronald B Hirschl, Samir K Gadepalli
BACKGROUND: Neurologic complications are common, and amongst the most devastating complications in pediatric patients undergoing extracorporeal life support (ECLS). Carotid artery cannulation (CAN) has been associated with an increase in these complications, thereby shaping practices to avoid this approach in most pediatric patients in which other cannulation approaches are viable. METHODS: A retrospective review of children (0-18years) in the ELSO database was undertaken from 1989 through 2013...
January 31, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29302124/extracorporeal-life-support-as-a-rescue-measure-for-managing-life-threatening-arrythmia-and-brugada-syndrome
#7
Asaad G Beshish, Allison Weinberg, Waseem Ostwani, Gabe E Owens
We describe the use of extracorporeal cardiopulmonary resuscitation (E-CPR) to transiently stabilize a 3-month-old patient who presented with ventricular tachyarrhythmias leading to spontaneous cardiac arrest. The patient required 4 days of extracorporeal life support (ECLS) where he was diagnosed with probable Brugada syndrome (BS). The patient was discharged home in stable condition after implantable cardioverter defibrillator placement. This case highlights the importance of early transfer to extracorporeal membrane oxygenation (ECMO) center in the setting of unexplained cardiac arrhythmia in a pediatric patient...
December 2017: Journal of Extra-corporeal Technology
https://www.readbyqxmd.com/read/28940550/evaluation-of-combined-extracorporeal-life-support-and-continuous-renal-replacement-therapy-on-hemodynamic-performance-and-gaseous-microemboli-handling-ability-in-a-simulated-neonatal-ecls-system
#8
Kaitlyn R Shank, Elizabeth Profeta, Shigang Wang, Christian O'Connor, Allen R Kunselman, Karl Woitas, John L Myers, Akif Ündar
The objective of this study was to evaluate the hemodynamic performance and gaseous microemboli (GME) handling ability of a simulated neonatal extracorporeal life support (ECLS) circuit with an in-line continuous renal replacement therapy (CRRT) device. The circuit consisted of a Maquet RotaFlow centrifugal pump or HL20 roller pump, Quadrox-iD Pediatric diffusion membrane oxygenator, 8-Fr arterial cannula, 10-Fr venous cannula, and Better-Bladder (BB) with "Y" connector. A second Quadrox-I Adult oxygenator was added postarterial cannula for GME experiments...
September 21, 2017: Artificial Organs
https://www.readbyqxmd.com/read/28840012/extracorporeal-support-in-airway-surgery
#9
REVIEW
Konrad Hoetzenecker, Walter Klepetko, Shaf Keshavjee, Marcelo Cypel
Extracorporeal life support (ECLS) is increasingly used for major airway surgery. It facilitates complex reconstructions and maintains gas exchange during endoscopic procedures in patients with critical airway obstruction. ECLS offers the advantage of an uncluttered surgical field and eliminates the need for crossing ventilation tubes, thus, making precise surgical dissection easier. ECLS is currently used for hemodynamic and respiratory support in lung transplantation as well as extended tumor resections with an acceptable risk profile...
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28816799/successful-extracorporeal-life-support-in-a-pediatric-hematopoietic-stem-cell-transplant-recipient-with-periengraftment-respiratory-failure
#10
Jenny Potratz, Martina Ahlmann, Claudia Rössig, Heymut Omran, Katja Masjosthusmann
The use of extracorporeal life support (ECLS) as ultimate salvage therapy for hematopoietic stem cell transplant recipients remains controversial among oncologists and critical care specialists. Prognosis is poor, particularly after allogeneic transplantation, and literature to guide clinical decision-making is scarce. Our report describes successful ECLS in a pediatric patient undergoing allogeneic hematopoietic stem cell transplantation, who developed acute respiratory failure during severe neutropenia, followed by immediate neutrophil engraftment...
August 14, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28782157/initial-clinical-experiences-with-novel-diagonal-ecls-system-in-pediatric-cardiac-patients
#11
Yildiz Okan, Haydin Sertac, Ozturk Erkut, Kasar Taner, Onan I Selen, Altin H Firat, Cine Nihat, Ayyildiz Pelin, Erkan Halime, Guzeltas Alper
Extracorporeal life support (ECLS) provides mechanical support following cardiac surgery when respiratory or cardiac failure occurs. The aim of this study was to analyze the safety and feasibility of the Medos Deltastream diagonal pump (DP3) ECLS system in pediatric cardiac patients. We described the technical considerations and risk factors related to the survival outcomes in 102 pediatric cardiac patients who received ECLS support between March 2011 and April 2016. We switched from the DP2 system, which was used for the initial 25 patients, to the DP3 system after November 2012...
August 2017: Artificial Organs
https://www.readbyqxmd.com/read/28693359/coagulation-monitoring-correlation-with-heparin-dose-in-pediatric-extracorporeal-life-support
#12
Katie Moynihan, Kerry Johnson, Lahn Straney, Christian Stocker, Ben Anderson, Prem Venugopal, John Roy
OBJECTIVES: Extracorporeal Life Support (ECLS) risks thrombotic and hemorrhagic complications. Optimal anti-coagulation monitoring is controversial. We compared coagulation tests evaluating the heparin effect in pediatric ECLS. METHODS: A retrospective study of children (<18yrs) undergoing ECLS over 12 months in a tertiary pediatric intensive care unit (PICU). Variables included anti-Factor Xa activity (anti-Xa), activated partial thromboplastin time (aPTT), activated clotting time (ACT) and thromboelastogram (TEG® 6s) parameters: ratio and delta reaction (R) times (the ratio and difference, respectively, between R times in kaolin assays with and without heparinase)...
November 2017: Perfusion
https://www.readbyqxmd.com/read/28621839/evaluation-of-hemodynamic-performance-of-a-combined-ecls-and-crrt-circuit-in-seven-positions-with-a-simulated-neonatal-patient
#13
Elizabeth Profeta, Kaitlyn Shank, Shigang Wang, Christian O'Connor, Allen R Kunselman, Karl Woitas, John L Myers, Akif Ündar
As it is common for patients treated with extracorporeal life support (ECLS) to subsequently require continuous renal replacement therapy (CRRT), and neonatal patients encounter limitations due to lack of access points, inclusion of CRRT in the ECLS circuit could provide advanced treatment for this population. The objective of this study was to evaluate an alternative neonatal ECLS circuit containing either a Maquet RotaFlow centrifugal pump or Maquet HL20 roller pump with one of seven configurations of CRRT using the Prismaflex 2000 System...
February 2018: Artificial Organs
https://www.readbyqxmd.com/read/28557863/pediatric-extracorporeal-life-support-organization-registry-international-report-2016
#14
Ryan P Barbaro, Matthew L Paden, Yigit S Guner, Lakshmi Raman, Lindsay M Ryerson, Peta Alexander, Viviane G Nasr, Melania M Bembea, Peter T Rycus, Ravi R Thiagarajan
The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers...
July 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28497033/intrapulmonary-percussive-ventilation-as-an-airway-clearance-technique-during-venoarterial-extracorporeal-life-support-in-an-infant-with-pertussis
#15
Conrad Krawiec, Ken Ballinger, E Scott Halstead
Initiation of extracorporeal life support (ECLS) is often followed by complete opacification of pulmonary parenchyma and volume loss. The optimal mechanical ventilator management and lung recruitment strategy of a pediatric patient requiring extracorporeal membrane oxygenation is not known. We present a case of a 4-week old infant who developed a severe pertussis infection requiring ECLS. The severity of his illness and pertussis infection-associated intraluminal bronchiole obstruction made medical management challenging...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28362356/severe-pneumonia-caused-by-influenza-a-h1n1-virus-successfully-managed-with-extracorporeal-life-support-in-a-comorbid-former-preterm-infant
#16
Genny Raffaeli, Giacomo Cavallaro, Lorenza Pugni, Ernesto Leva, Andrea Artoni, Simona Neri, Chiara Baracetti, Mauro Cotza, Valerio Gentilino, Leonardo Terranova, Susanna Esposito, Fabio Mosca
Influenza A (H1N1) virus infection is a global health burden, leading to significant pediatric morbidity and mortality. Prematurity, young age and comorbidities are important risk factors for unfavorable outcomes. Preventive strategies, such as healthcare workers and household contacts vaccination as well as the implementation of infection control practices during the epidemic season, are crucial to protect the most vulnerable populations. Early diagnosis, timely administration of antiviral drugs and supportive therapy are crucial to lead to a complete recovery...
March 31, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28349236/concurrent-trajectories-of-female-drinking-and-smoking-behaviors-throughout-transitions-to-pregnancy-and-early-parenthood
#17
Weiwei Liu, Elizabeth A Mumford
The purpose of this longitudinal study was to investigate whether there are distinct etiological processes explaining dual usage of alcohol and conventional cigarettes by mothers from preconception through the early parenting years. Data on 8800 biological mothers were drawn from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B), representative of US births in 2001. A general growth mixture model (GGMM) was used to empirically identify developmental trajectories of maternal smoking and drinking over the 5-6-year study period...
May 2017: Prevention Science: the Official Journal of the Society for Prevention Research
https://www.readbyqxmd.com/read/28301052/decreased-blood-product-usage-during-extracorporeal-life-support-with-reduced-circuit-volumes
#18
Samuel D Addison, Marcia L Buck, Gary Y Fang, James J Gangemi, David A Kaufman
BACKGROUND: Activation and consumption of platelets (PLT) and clotting factors along with hemolysis occurs when blood contacts the extracorporeal life support (ECLS) circuit and its components. STUDY DESIGN AND METHODS: The objective was to examine the effects of reducing ECLS circuit volume by decreasing tubing length and changing components on blood product usage in neonatal and pediatric patients. Blood product administration was analyzed in 40 consecutive patients who required ECLS for respiratory or cardiac failure before (PRE) and after (POST) changes in circuit design and components...
June 2017: Transfusion
https://www.readbyqxmd.com/read/28289880/pediatric-morgagni-diaphragmatic-hernia-a-descriptive-study
#19
Jamie Golden, Wesley E Barry, Gene Jang, Nam Nguyen, David Bliss
INTRODUCTION: The Morgagni hernia (MH) accounts for 3-4% of congenital diaphragmatic hernias. There is a paucity of data regarding this rare defect. The purpose of this study is to describe the characteristics of children with MH, surgical approaches for repair, and patient outcomes. METHODS: Pediatric patients (ages 0-18) with a MH from 2002 to 2014 at a single, freestanding pediatric hospital were retrospectively reviewed. Patient presentation, demographics, operative methods and findings, and outcomes were evaluated...
July 2017: Pediatric Surgery International
https://www.readbyqxmd.com/read/28271557/early-cardiac-catheterization-leads-to-shortened-pediatric-extracorporeal-membrane-oxygenation-run-duration
#20
Christopher R Burke, Titus Chan, Agustin E Rubio, David M McMullan
OBJECTIVE: Cardiac catheterization in patients receiving extracorporeal life support (ECLS) has previously been shown to be safe and, in many cases, therapeutic. However, the influence of cardiac catheterization on clinical outcomes in this patient population has not been clearly defined. METHODS: A single institution, retrospective review of all pediatric cardiac ECLS patients who underwent cardiac catheterization between January 2006 and September 2015 was performed...
April 2017: Journal of Interventional Cardiology
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