Extracorporeal life support: Updates and controversies

Gadepalli, Samir K.; Hirschl, Ronald B.

doi:10.1053/j.sempedsurg.2014.11.002

Cited by 16 publications

(9 citation statements)

References 65 publications

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“…A priori , we chose 2009 as the start date for data accrual because advances in ECMO technology from that year onward have been reported to enhance delivery of ECMO support [18,19]. If a patient was placed on ECMO more than once, we only considered the first ECMO run.…”

Section: Methodsmentioning

confidence: 99%

“…We queried the ELSO registry for all pediatric patients aged 29 days to <18 years who received ECMO support for respiratory failure from 2009–2014. A priori , we chose 2009 as the start date for data accrual because advances in ECMO technology from that year onward have been reported to enhance delivery of ECMO support [18,19]. If a patient was placed on ECMO more than once, we only considered the first ECMO run.…”

Section: Methodsmentioning

confidence: 99%

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Development and validation of the pediatric risk estimate score for children using extracorporeal respiratory support (Ped-RESCUERS)

et al. 2016

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Development and validation of the pediatric risk estimate score for children using extracorporeal respiratory support (Ped-RESCUERS)

et al. 2016

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“…Furthermore, the ECLS technology applied to patients has also evolved with a predominance of centrifugal pumps over roller pumps, a minimization of silicone oxygenators, and the broad availability of dual lumen cannulas for patients of nearly all sizes. 11,12 …”

Section: Introductionmentioning

confidence: 99%

Pediatric Extracorporeal Life Support Organization Registry International Report 2016

et al. 2017

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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. By 2015, that number grew to 2,992 cases in 227 centers, reflecting a 24% increase in patients and 55% growth in centers. ECLS delivered to neonates (0–28 days) for respiratory support was the largest subcategory of ECLS among children <18 years old. Overall, 48% of ECLS was delivered for respiratory support and 52% was for cardiac support or extracorporeal life support to support cardiopulmonary resuscitation (ECPR). During the study period, over half of children were supported on ECLS with centrifugal pumps (51%) and polymethylpentene oxygenators (52%). Adverse events including neurologic events were common during ECLS, a fact that underscores the opportunity and need to promote quality improvement work.

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“…Venoarterial (VA) and venovenous (VV) ECMO are gaining acceptance as a standard of care for lung failure refractory to conventional treatment ( 2 , 3 ), and VADs are increasingly utilized for pediatric heart failure ( 4 ). However, there are patients whose anatomy, specific etiology of lung failure, or concomitant requirements for other organ support devices have led practitioners to look for new ways to apply the underlying ECMO and VAD technology to treat their patients.…”

Section: Introductionmentioning

confidence: 99%

Paracorporeal Lung Devices: Thinking Outside the Box

2018

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Extracorporeal Membrane Oxygenation (ECMO) is a resource intensive, life-preserving support system that has seen ever-expanding clinical indications as technology and collective experience has matured. Clinicians caring for patients who develop pulmonary failure secondary to cardiac failure can find themselves in unique situations where traditional ECMO may not be the ideal clinical solution. Existing paracorporeal ventricular assist device (VAD) technology or unique patient physiologies offer the opportunity for thinking “outside the box.” Hybrid ECMO approaches include splicing oxygenators into paracorporeal VAD systems and alternative cannulation strategies to provide a staged approach to transition a patient from ECMO to a VAD. Alternative technologies include the adaptation of ECMO and extracorporeal CO2 removal systems for specific physiologies and pediatric aged patients. This chapter will focus on: (1) hybrid and alternative approaches to extracorporeal support for pulmonary failure, (2) patient selection and, (3) technical considerations of these therapies. By examining the successes and challenges of the relatively select patients treated with these approaches, we hope to spur appropriate research and development to expand the clinical armamentarium of extracorporeal technology.

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Extracorporeal life support: Updates and controversies

Cited by 16 publications

References 65 publications

Development and validation of the pediatric risk estimate score for children using extracorporeal respiratory support (Ped-RESCUERS)

Development and validation of the pediatric risk estimate score for children using extracorporeal respiratory support (Ped-RESCUERS)

Pediatric Extracorporeal Life Support Organization Registry International Report 2016

Paracorporeal Lung Devices: Thinking Outside the Box

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