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Pediatric ecmo

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https://www.readbyqxmd.com/read/29774549/extracorporeal-membrane-oxygenation-characteristics-and-outcomes-in-adult-patients-with-down-syndrome
#1
Vicky Duffy, Daniel Gomez, Peter Rycus, Brian Rivera, Stephanie L Santoro, Carl H Backes, Clifford L Cua
Patients with Down syndrome (DS) may have multiple medical issues that place them at risk for requiring extracorporeal membrane oxygenation. Use of extracorporeal membrane oxygenation in pediatric patients with Down syndrome has been described, but minimal data exist for extracorporeal membrane oxygenation use in adults with Down syndrome. The goal of this study was to describe the clinical characteristics and to determine if there were differences between adult extracorporeal membrane oxygenation patients with Down syndrome that were alive (aDS) versus those that died (dDS) prior to hospital discharge...
May 17, 2018: Artificial Organs
https://www.readbyqxmd.com/read/29770298/mitochondrial-transplantation-applications-for-pediatric-patients-with-congenital-heart-disease
#2
REVIEW
Sitaram M Emani, James D McCully
Mitochondrial transplantation refers to transplantation of respiratory competent mitochondria from healthy tissue into tissues injured by ischemia and reperfusion. This technique has been utilized for recovery of myocardial dysfunction in pediatric patients. The preclinical experience and initial patient experience with this technique are reviewed in this article. Initial experience is with pediatric patients undergoing extracorporeal membrane oxygenation support following myocardial ischemia and reperfusion...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29762231/surfactant-administration-during-pediatric-cardiac-extracorporeal-membrane-oxygenation
#3
Constantinos Chrysostomou, Timothy Maul, Filip Istvanic, Peter Wearden
We investigated the safety and efficacy of surfactant during extracorporeal membrane oxygenation (ECMO) in children with cardiac disease. ECMO patients administered surfactant (surfactant group) were compared with patients who did not receive (control). Criteria to administer surfactant were based on a decreased lung compliance of <0.5 ml/kg/cm H2O. Efficacy was determined on pulmonary compliance change and the radiography-based respiratory distress severity (RDS) score. For the surfactant group, lung compliance measurements and RDS scores were obtained just before the first surfactant administration (T0), 24 hours after the last dose of surfactant (T1), and 24 hours after ECMO decannulation (T2)...
May 11, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746314/impact-of-anticoagulation-and-circuit-technology-on-complications-during-extracorporeal-membrane-oxygenation
#4
Robert A Niebler, Hinah Parker, George M Hoffman
The objective of this study is to evaluate the impact a change in anticoagulation protocol and circuit technology had on bleeding and thrombotic complications in patients supported on extracorporeal membrane oxygenation (ECMO). A retrospective review at a tertiary, academic pediatric intensive care unit was undertaken. The anticoagulation protocol changed from targeting an activated clotting time (ACT) to anti-Xa level. Significant changes in the ECMO circuit were undertaken concurrently. One-hundred and fifty-two ECMO runs in 129 patients in the ACT target group were compared with 122 ECMO runs in 101 patients in the anti-Xa target group...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29746311/evaluating-mortality-risk-adjustment-among-children-receiving-extracorporeal-support-for-respiratory-failure
#5
Ryan P Barbaro, Philip S Boonstra, Kevin W Kuo, David T Selewski, David K Bailly, Cheryl L Stone, Chin Ying Chow, Gail M Annich, Frank W Moler, Matthew L Paden
This study evaluates whether three commonly used pediatric intensive care unit (PICU) severity of illness scores, pediatric risk of mortality score (PRISM) III, pediatric index of mortality (PIM) 2, and pediatric logistic organ dysfunction (PELOD), are the appropriate tools to discriminate mortality risk in children receiving extracorporeal membrane oxygenation (ECMO) support for respiratory failure. This study also evaluates the ability of the Pediatric Risk Estimate Score for Children Using Extracorporeal Respiratory Support (Ped-RESCUERS) to discriminate mortality risk in the same population, and whether Ped-RESCUERS' discrimination of mortality is improved by additional clinical and laboratory measures of renal, hepatic, neurologic, and hematologic dysfunction...
May 8, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29744657/transcatheter-intervention-of-coronary-obstructions-in-infants-children-and-young-adults
#6
Ryan Callahan, James E Lock, Pinak B Shah, Audrey C Marshall
This study assesses the characteristics of coronary obstructions that underwent transcatheter intervention in a pediatric catheterization laboratory, the procedural details, and patient outcomes. Acute cardiac failure due to coronary obstructions in children is rare. The role of catheter based intervention is largely unreported. Single center retrospective review between January 2000 and December 2016. Thirty-three patients (median age 2y/o [0-38], weighing 9.6 kg [2.2-91]) underwent 39 transcatheter interventions on 39 lesions, mainly left main coronary (16/39; 39%) and right coronary (9/39; 23%) arteries...
May 9, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29732182/drugs-pharmacokinetics-during-veno-venous-extracorporeal-membrane-oxygenation-in-pediatrics
#7
REVIEW
Matteo Di Nardo, Enno Diederick Wildschut
Data evaluating pharmacokinetic/pharmacodynamic (PK/PD) aspect in the pediatric population are scarce especially regarding the pediatric intensive care unit. Dosing of frequently used drugs (sedatives, analgesics, antibiotics and cardiovascular drugs) are mainly based on non "pediatric intensive care unit (PICU)" patients, and sometimes are translated from adult patients. Among PICU patients, the most complex patients are the ones who are critically ill and are receiving mechanical circulatory/respiratory support for cardiac and/or respiratory failure...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29698335/pediatric-veno-veno-extracorporeal-membrane-oxygenation-rescue-from-carbon-monoxide-poisoning
#8
David A Baran, Kelly Stelling, Derrick McQueen, Mark Pearson, Vaishali Shah
BACKGROUND: Carbon monoxide poisoning affects approximately 5000 children per year and can be challenging to diagnose and treat (Pediatr Emerg Med Pract. 2016;13:1-24). It is in the differential diagnosis of a patient presented with altered consciousness. Patients may look quite "pink" and well perfused, but are often in serious distress. We present the first case in the literature of carbon monoxide poisoning treated with the use of veno-veno extracorporeal membrane oxygenation (ECMO)...
April 25, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29681396/racial-variations-in-extracorporeal-membrane-oxygenation-use-following-congenital-heart-surgery
#9
Titus Chan, Cindy S Barrett, Yuen Lie Tjoeng, Jacob Wilkes, Susan L Bratton, Ravi R Thiagarajan
OBJECTIVES: Previous studies demonstrate racial and ethnic disparities among children undergoing congenital heart surgery. Extracorporeal membrane oxygenation (ECMO) is used to support critically ill children after congenital heart surgery and improve survival. Thus, racial or ethnic variations in postoperative ECMO use following congenital heart surgery may be associated with racial/ethnic disparities in hospital survival. METHODS: All children in the Pediatric Health Information Systems dataset undergoing congenital heart surgery from 2004 to 2015 were examined...
April 6, 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29677081/changes-in-pediatric-heart-transplant-hospitalization-costs-over-time
#10
Justin Godown, Cary Thurm, Matt Hall, Jonathan H Soslow, Brian Feingold, Bret A Mettler, Andrew H Smith, David W Bearl, Debra A Dodd
BACKGROUND: Despite significant changes in the past decade for children undergoing heart-transplantation, including the evolution of mechanical circulatory support and increasing patient complexity, costs and resource utilization have not been reassessed. We sought to utilize a novel linkage of clinical-registry and administrative data to examine changes in hospitalization costs over time in this population. METHODS: We identified all pediatric heart transplant recipients in a unique linked PHIS/SRTR dataset (2002-2016)...
April 19, 2018: Transplantation
https://www.readbyqxmd.com/read/29659415/functional-status-change-among-children-with-extracorporeal-membrane-oxygenation-to-support-cardiopulmonary-resuscitation-in-a-pediatric-cardiac-icu-a-single-institution-report
#11
Asaad G Beshish, Mathew R Baginski, Thomas J Johnson, Barry K Deatrick, Ryan P Barbaro, Gabe E Owens
OBJECTIVES: The purpose of this study is to describe the functional status of survivors from extracorporeal cardiopulmonary resuscitation instituted during in-hospital cardiac arrest using the Functional Status Scale. We aimed to determine risk factors leading to the development of new morbidity and unfavorable functional outcomes. DESIGN: This was a single-center retrospective chart review abstracting patient characteristics/demographic data, duration of cardiopulmonary resuscitation, duration of extracorporeal membrane oxygenation support, as well as maximum lactate levels within 2 hours before and after extracorporeal cardiopulmonary resuscitation...
April 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29623729/pharmacokinetic-considerations-for-pediatric-patients-receiving-analgesia-in-the-intensive-care-unit-targeting-postoperative-ecmo-and-hypothermia-patients
#12
Gerdien A Zeilmaker, Paula Pokorna, Paola Mian, Enno D Wildschut, Catherijne A J Knibbe, Elke H J Krekels, Karel Allegaert, Dick Tibboel
Adequate postoperative analgesia in pediatric patients in the intensive care unit (ICU) matters, since untreated pain is associated with negative outcomes. Compared to routine postoperative patients, children undergoing hypothermia (HT) or extracorporeal membrane oxygenation (ECMO), or recovering after cardiac surgery likely display non-maturational differences in pharmacokinetics (PK) and pharmacodynamics (PD). These differences warrant additional dosing recommendations to optimize pain treatment. Areas covered: Specific populations within the ICU will be discussed with respect to expected variations in PK and PD for various analgesics...
April 2018: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/29621235/survival-after-picu-admission-the-impact-of-multiple-admissions-and-complex-chronic-conditions
#13
Håkan Kalzén, Björn Larsson, Staffan Eksborg, Lars Lindberg, Karl Erik Edberg, Claes Frostell
OBJECTIVE: Factors predicting survival over time after pediatric intensive care unit (PICU) admissions are not fully understood. The primary aim of the current study was to investigate whether multiple admissions (MADM) compared to single PICU admissions (SADM) were associated with poor survival over time after being admitted to PICU facilities. Our secondary aim was to investigate if the presence of a complex chronic condition (CCC) would further impair prognosis. DESIGN: A closed cohort of all children up to 16 years of age admitted to the three PICUs in Sweden between 2008 and 2010 was prospectively collected and followed until 2012, providing survival data for at least one but up to four years of follow-up...
2018: PloS One
https://www.readbyqxmd.com/read/29617575/do-we-really-doubt-ecmo-efficacy-in-pediatric-ards
#14
Jerome Rambaud, Yohann Soreze, Pierre-Louis Leger
No abstract text is available yet for this article.
April 4, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29617573/reply-to-do-we-really-doubt-ecmo-efficacy-in-pediatric-ards
#15
Ryan P Barbaro, Ravi R Thiagarajan, David Wypij, Martha A Q Curley
No abstract text is available yet for this article.
April 4, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29616201/cannulation-for-neonatal-and-pediatric-extracorporeal-membrane-oxygenation-for-cardiac-support
#16
REVIEW
Chris Harvey
The use of extracorporeal membrane oxygenation (ECMO) has increased over recent years providing respiratory and cardiac support. Optimal cannula placement is essential for successful patient outcomes. Multiple cannulation strategies may be employed depending on the age/weight of the patient and their underlying condition. This article discusses cannulation technique focusing on the cannulation of pediatric and neonatal patients for cardiac support on ECMO.
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29614572/-four-cases-of-acute-respiratory-distress-syndrome-patients-transported-with-veno-venous-extracorporeal-membrane-oxygenation
#17
Z Zhao, X Y Hong, Y Y Liu, X J Zhang, L S Bao, H T Gao, X H Liu, Z C Feng
Objective: To retrospectively review 4 cases diagnosed with pediatric acute respiratory distress syndrome (ARDS) who were transported with veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) from April 2016 to March 2017. Methods: Four patients were transported to Bayi Children's Hospital Afflicted to the PLA Army General Hospital, with V-V ECMO. Their vital signs, blood-gas analysis and chest X-ray before and after transportation were compared. The length of ECMO, pediatric intensive care unit (PICU) stay and hospitalization, and the prognosis were analyzed...
April 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29613889/extracorporeal-membrane-oxygenation-in-a-pediatric-patient-with-hepatopulmonary-syndrome-and-interrupted-inferior-vena-cava-after-living-related-liver-donation
#18
Michael R Phillips, Marc Priest, Christopher Beaty, Robert Parker, Marisa Meyer, Stephen Dunn, Curtis D Froehlich, Daniel R Dirnberger, Abigail E Martin, Mark T Ogino
Extracorporeal membrane oxygenation (ECMO) is used for cardiopulmonary dysfunction. Hepatopulmonary syndrome (HPS) occurs in the setting of liver failure and may cause hypoxemia. Previous reports have described the use of ECMO for HPS after liver transplant. Our patient is a 19-month-old female with biliary atresia, an interrupted inferior vena cava, and HPS on 8 liters per minute of high-flow oxygen. Following liver transplantation, her postoperative course was complicated by severe hypoxemia requiring ECMO...
March 30, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29605581/hematological-complications-in-children-subjected-to-extracorporeal-membrane-oxygenation
#19
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/29603269/nutrition-delivery-during-pediatric-extracorporeal-membrane-oxygenation-therapy
#20
Lindsey B Armstrong, Katelyn Ariagno, Craig D Smallwood, Charles Hong, Mary Arbuthnot, Nilesh M Mehta
BACKGROUND: Macronutrient delivery during pediatric ECMO therapy can be challenging. We examined predictors of nutrient delivery in the first 2 weeks of extracorporeal membrane oxygenation (ECMO) therapy in the pediatric intensive care unit (ICU). METHODS: Details of macronutrient delivery were recorded in children (newborn-18 years of age) who survived 24 hours after cannulation to ECMO over a 3-year period (2012-2015). RESULTS: We analyzed data from 54 consecutive eligible patients, 43% female, with median (interquartile range) ECMO duration of 8...
March 30, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
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