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ECMO, ECLS, Pediatric ECMO, Pediatric intensive care

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
Makbule Nilüfer Öztürk, Koray Ak, Nilgün Erkek, Edanur Yeşıl, Muhterem Duyu, Pınar Yazici, Ayşen Yaprak Engın, Bülent Karapinar
BACKGROUND/AIM: Extracorporeal membrane oxygenation (ECMO) is a unique life-support modality offered to patients unresponsive to optimal medical therapy. The aim of this study was to evaluate early experiences with ECMO support in 2 tertiary Turkish pediatric intensive care units (PICUs). MATERIALS AND METHODS: We retrospectively evaluated a total of 10 ECMO-supported patients between March 2012 and March 2013 in Marmara and Ege University Hospital PICUs. We reported data regarding demographics, laboratory and diagnostic information, and the clinical course of the patients...
2014: Turkish Journal of Medical Sciences
Jeffrey J Cies, Wayne S Moore, Mindy J Dickerman, Christine Small, Dominick Carella, Arun Chopra, Jason Parker
Meropenem, a broad-spectrum carbapenem, is commonly used for empirical and definitive therapy in the pediatric intensive care unit (ICU). Pharmacokinetic data to guide dosing in children, however, are limited to healthy volunteers or patients who are not in the ICU. Adult data demonstrate that pharmacokinetic parameters such as the volume of distribution and clearance can be significantly altered in individuals receiving extracorporeal membrane oxygenation (ECMO). Alterations in the volume of distribution and clearance of antimicrobials in patients with sepsis and septic shock have also been documented, and these patients have demonstrated lower than expected antimicrobial serum concentrations based on standard dosing regimens...
October 2014: Pharmacotherapy
Jess L Thompson, Lisa M Grisham, Jeanne Scott, Chris Mogan, Hannes Prescher, David Biffar, John Jarred, Robyn J Meyer, Allan J Hamilton
Initiation of extracorporeal membrane oxygenation (ECMO) is stressful, especially for inexperienced extracorporeal life support providers. The main objective of this study was to create a novel, reusable mannequin for high-fidelity simulation of ECMO initiation. We modified a Laerdal neonatal mannequin (SimNewB; Stavanger, Norway) so that it could be used to simulate an ECMO initiation. A simulation of a neonatal patient suffering from meconium aspiration was performed in the pediatric intensive care unit, and participants included new extracorporeal life support specialists in addition to the composition of the clinical ECMO team...
April 2014: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
L B Mongero, J R Beck, K A Charette
Extracorporeal membrane oxygenation (ECMO) is an extracorporeal technique of providing both cardiac and respiratory support to patients whose heart and lungs are so severely diseased or damaged that they can no longer serve their function. Neonatal and pediatric ECMO was accepted as practice in the early 1990s and according to the Extracorporeal Life Support Organization, ELSO; of the >50,000 patients registered, 73% have survived extracorporeal life support (ECLS). It is not uncommon to find initial cannulation of a patient receiving ECMO performed by a surgeon and then the maintenance of the patient being left in the hands of various others deemed as the "ECMO Specialists"...
November 2013: Perfusion
Kate L Brown, Rebecca Ichord, Bradley S Marino, Ravi R Thiagarajan
Extracorporeal membrane oxygenation is a commonly used form of mechanical circulatory support in children with congenital or acquired heart disease and cardiac failure refractory to conventional medical therapies. In children with heart disease who suffer cardiac arrest, extracorporeal membrane oxygenation has been successfully used to provide cardiopulmonary support when conventional resuscitation has failed to establish return of spontaneous circulation. Survival to hospital discharge for children with heart disease support is approximately 40% but varies widely based on age, indication for support, and underlying cardiac disease...
June 2013: Pediatric Critical Care Medicine
V Ben Sivarajan, Mel C Almodovar, Mark D Rodefeld, Peter C Laussen
OBJECTIVES: The purpose of this review was to provide a systematic review of the literature regarding the use of extracorporeal life support (ECLS) in various specialized conditions, as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support. DATA SOURCES: MEDLINE and PubMed. STUDY SELECTION: Searches for published abstracts and articles were conducted using the following MeSH terms: extracorporeal life support, extracorporeal membrane oxygenation, or mechanical support, and pediatric or children...
June 2013: Pediatric Critical Care Medicine
Steven M Schwartz, Alicia Schmidt
OBJECTIVES: To review the medical and nursing care of children receiving mechanical circulatory support as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support. DATA SOURCES/STUDY SELECTION/DATA EXTRACTION/DATA SYNTHESIS: This is a general review of current issues of medical and nursing care of children on mechanical circulatory support. It consists of knowledge gained from practical experience combined with supporting evidence and/or discussion of controversies for which evidence exists or is inconclusive...
June 2013: Pediatric Critical Care Medicine
Robert D B Jaquiss, Ronald A Bronicki
OBJECTIVE: For children with severe heart failure in whom medical management has failed, mechanical circulatory support in the form of either extracorporeal membrane oxygenation or ventricular assist device represents life-sustaining therapy. This review provides an overview of these two modalities, including a discussion of indications, contraindications, timing, and device selection, as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support...
June 2013: Pediatric Critical Care Medicine
Warwick Butt, Micheal Heard, Giles J Peek
The clinical management of patients on extracorporeal membrane oxygenation should be standardized and follow clear guidelines or protocols. However, due to the diversity of cannulation strategies and the complex situations that extracorporeal membrane oxygenation is now used in, each extracorporeal membrane oxygenation program has developed its own clinical management strategies. These vary widely across the globe. Extracorporeal membrane oxygenation provides partial or complete support of ventilation and oxygenation, as well as univentricular or biventricular support of myocardial function, either individually or in combination...
June 2013: Pediatric Critical Care Medicine
Graeme MacLaren, Ali Dodge-Khatami, Heidi J Dalton, Graeme MacLaren, Ali Dodge-Khatami, Heidi J Dalton, Iki Adachi, Melvin Almodovar, Gail Annich, Robert Bartlett, Ronald Bronicki, Katherine Brown, Warwick Butt, David Cooper, Markus Demuth, Yves D'Udekem, Charles Fraser, Anne-Marie Guerguerian, Micheal Heard, Steven Horton, Rebecca Ichord, Robert Jaquiss, Peter Laussen, Laurance Lequier, Song Lou, Bradley Marino, Michael McMullan, Mark Ogino, Giles Peek, Rene Pretre, Mark Rodefeld, Alicia Schmidt, Steven Schwartz, Lara Shekerdemian, Nobuaki Shime, Ben Sivarajan, Brigitte Stiller, Ravi Thiagarajan
No abstract text is available yet for this article.
June 2013: Pediatric Critical Care Medicine
Ardith Z Doorenbos, Helene Starks, Erica Bourget, D Michael McMullan, Mithya Lewis-Newby, Tessa C Rue, Taryn Lindhorst, Eugene Aisenberg, Natalie Oman, J Randall Curtis, Ross Hays, Jonna D Clark, Harris P Baden, Thomas V Brogan, Jane L Di Gennaro, Robert Mazor, Joan S Roberts, Jessica Turnbull, Benjamin S Wilfond
BACKGROUND: Extracorporeal life support (ECLS) is an advanced form of life-sustaining therapy that creates stressful dilemmas for families. In May 2009, Seattle Children's Hospital (SCH) implemented a policy to involve the Pediatric Advanced Care Team (PACT) in all ECLS cases through automatic referral. OBJECTIVE: Our aim was to describe PACT involvement in the context of automatic consultations for ECLS patients and their family members. METHODS: We retrospectively examined chart notes for 59 consecutive cases and used content analysis to identify themes and patterns...
May 2013: Journal of Palliative Medicine
Pierre-Louis Léger, Julia Guilbert, Ségolène Isambert, Nolwenn Le Saché, Fazia Hallalel, Alain Amblard, Jean-Yves Chevalier, Sylvain Renolleau
Single-lumen cannula venovenous (VV) extracorporeal membrane oxygenation (ECMO) is a special extracorporeal life support (ECLS) technique used for neonatal and pediatric refractory hypoxemia. This is an alternative flow rate ECLS that consists of successive clamping on the drainage and the injection lines. Currently, the Armand-Trousseau's pediatric intensive care unit remains the only pediatric ECMO center proposing this partial assistance. This article details a technical note and a retrospective analysis of our experience in refractory hypoxemia...
January 2013: Artificial Organs
Heidi J Dalton, Warwick W Butt
INTRODUCTION: The field of extracorporeal life support, which has focused predominantly on extracorporeal membrane oxygenation in the past, is undergoing rapid expansion following years of stagnation as newer devices and improved technology have become available. Additionally, new cannulae and cannulation techniques have allowed extracorporeal life support to be expanded to many groups who would have been excluded from support in the past. REVIEW: This update will review the current state of the art since Rogers' Textbook of Pediatric Intensive Care (Fourth Edition) was published several years ago...
July 2012: Pediatric Critical Care Medicine
Michele B Domico, Deborah A Ridout, Ronald Bronicki, Nick G Anas, John Patrick Cleary, James Cappon, Allan P Goldman, Katherine L Brown
OBJECTIVE: To evaluate the relationship between duration of mechanical ventilation before the initiation of extracorporeal life support and the survival rate in children with respiratory failure. Extracorporeal life support has been used as a rescue therapy for >30 yrs in children with severe respiratory failure. Previous studies suggest patients who received >7-10 days of mechanical ventilation were not acceptable extracorporeal life support candidates as a result of irreversible lung damage...
January 2012: Pediatric Critical Care Medicine
Sameer Khan, Rahul Vasavada, Feng Qiu, Allan Kunselman, Akif Undar
Emerging technologies and practices for pediatric and neonatal extracorporeal life support (ECLS) are promising. This experiment sought to compare the Medtronic 0800 silicon rubber membrane oxygenator to the Quadrox-iD Pediatric oxygenator in the conventional roller pump circuit, as well as comparing the conventional circuit to an alternative circuit. Three circuits were set up in the experiment. Two conventional roller pump circuits were used to compare the two oxygenators and an alternative circuit consisting of the Quadrox-iD Pediatric oxygenator and Maquet Rotaflow centrifugal pump system was used to identify differences between circuits...
May 2011: Perfusion
Helen E Rowlands, Allan P Goldman, Karen Harrington, Ann Karimova, Joe Brierley, Nigel Cross, Sophie Skellett, Mark J Peters
OBJECTIVES: Bordetella pertussis is a common, underrecognized, and vaccine-preventable cause of critical illness with a high mortality in infants worldwide. Patients with severe cases present with extreme leukocytosis and develop refractory hypoxemia and pulmonary hypertension that is unresponsive to maximal intensive care. This may reflect a hyperviscosity syndrome from the raised white blood cell (WBC) count. Case reports suggest improved outcomes with exchange transfusion to reduce the WBC count...
October 2010: Pediatrics
Sujata Subramanian, Jonna D Clark, Howard E Jeffries, D Michael McMullan
OBJECTIVE: To report a case of pH1N1 viral infection presenting as heart failure requiring mechanical extracorporeal life support. DESIGN: Case report. SETTING: Pediatric intensive care unit at a regional children's hospital. PATIENT: Obese 15-yr-old boy who presented with pH1N1-related cardiomyopathy and respiratory failure that required extracorporeal membrane oxygenation. INTERVENTIONS: Extracorporeal membrane oxygenation, echocardiography, high-frequency oscillating ventilation...
November 2010: Pediatric Critical Care Medicine
Darren H Freed, Dietrich Henzler, Chris W White, Robert Fowler, Ryan Zarychanski, Jamie Hutchison, Rakesh C Arora, Rizwan A Manji, Jean-Francois Legare, Tanya Drews, Stasa Veroukis, Murray Kesselman, Anne-Marie Guerguerian, Anand Kumar
BACKGROUND: From March to July 2009, influenza A (H1N1) 2009 (H1N1-2009) virus emerged as a major cause of respiratory failure that required mechanical ventilation. A small proportion of patients who had this condition developed severe respiratory failure that was unresponsive to conventional therapeutic interventions. In this report, we describe characteristics, treatment, and outcomes of critically ill patients in Canada who had H1N1-2009 infection and were treated with extracorporeal lung support (ECLS)...
March 2010: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Susan H Morris, Ann E Haight, Pradip Kamat, James D Fortenberry
OBJECTIVE: To describe the successful use of extracorporeal life support in a hematopoietic stem cell transplant patient with diffuse alveolar hemorrhage. DESIGN: Case report. SETTING: Pediatric intensive care unit in a freestanding quaternary children's hospital. PATIENT: A 20-mo-old male with Hurler syndrome who developed respiratory failure from diffuse alveolar hemorrhage after hematopoietic stem cell transplant and was managed successfully with extracorporeal life support...
January 2010: Pediatric Critical Care Medicine
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