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Extracorporeal membrane oxygenation. Saving tiny lives
1Medical University of South Carolina, Charleston, South Carolina, USA.
Insights
Neonatal nurses from critical care areas collaborate to manage infants with congenital diaphragmatic hernia (CDH). Understanding extracorporeal membrane oxygenation (ECMO) benefits and limitations is crucial for optimal care.
Area of Science:
- Neonatal care
- Pediatric surgery
- Critical care medicine
Background:
- Infants with congenital diaphragmatic hernia (CDH) require complex care from multidisciplinary teams.
- Care involves neonatal intensive care unit (NICU), extracorporeal membrane oxygenation (ECMO) unit, and operating room (OR) personnel.
- Nursing care significantly impacts patient outcomes during preoperative, intraoperative, and postoperative phases.
Observation:
- The nursing team prioritizes the infant's physiological status and the family's psychosocial well-being.
- Extracorporeal membrane oxygenation (ECMO) remains controversial due to unknown long-term effects on survivors.
- ECMO provides an alternative for CDH infants when conventional treatments are insufficient.
Findings:
- A coordinated nursing team is essential for managing CDH infants.
- Understanding ECMO's benefits and limitations is vital for the care team.
- Multidisciplinary collaboration is key to managing this challenging patient population.
Implications:
- Continued evaluation of treatment modalities and techniques is necessary.
- Enhanced understanding of ECMO is required for optimal CDH infant care.
- Multidisciplinary teams must adapt and update practices to improve outcomes for neonates with CDH.
Abstract:
Infants with CDH require a dedicated nursing team that often comes from three different critical care areas: neonatal ICU, the ECMO unit, and the operating room. The team works together to directly affect the outcome of these infants through their preoperative, intraoperative, and postoperative care. The physiologic status of the patient and the psychosocial aspects of the family unit are of prime concern to the nursing team involved. Controversy still surrounds the use of ECMO because long-term effects on its survivors are unknown. It will be important for members of the team that manages the infant diagnosed with CDH to understand the benefits and limitations of ECMO. Even with its controversial aspects, ECMO offers the infant with CDH an alternative when conventional therapy fails. The collaborative efforts of the multidisciplinary team that manages these neonates must continue to evaluate treatment modalities and update techniques to maintain quality of care for this challenging population.