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Experience with extracorporeal membrane oxygenation in children more than one month old
1Intensive Care Unit, Royal Children's Hospital, Melbourne, Victoria, Australia.
Insights
Extracorporeal membrane oxygenation (ECMO) offers a vital treatment for children with severe cardiorespiratory failure. This therapy shows promising survival rates, enabling a return to normal life for many critically ill pediatric patients.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary support technologies
Background:
- Life-threatening respiratory or cardiac failure in children presents significant treatment challenges.
- Established treatment protocols for pediatric cardiorespiratory failure have limitations.
Purpose of the Study:
- To evaluate the efficacy and outcomes of Extracorporeal Membrane Oxygenation (ECMO) in pediatric patients with cardiorespiratory failure.
- To assess the survival rates and long-term functional status of children treated with ECMO.
Main Methods:
- Retrospective analysis of pediatric patients treated with ECMO from May 1988.
- Inclusion criteria: reversible disease, potential for acceptable quality of life, and high mortality risk without ECMO.
Main Results:
- Eighteen children received ECMO, with seven surviving to hospital discharge.
- All surviving children demonstrated normal functional outcomes.
- Results are comparable to international benchmarks for ECMO therapy.
Conclusions:
- Extracorporeal membrane oxygenation is a valuable therapeutic option for select pediatric cases of fatal cardiorespiratory failure.
- ECMO can lead to survival with good quality of life in critically ill children.
- The study supports the continued use of ECMO in specialized pediatric centers.
Abstract:
Extracorporeal membrane oxygenation (ECMO) has been used at the Royal Children's Hospital, Melbourne, in the treatment of children with life-threatening respiratory or cardiac failure since May 1988. The main indications for its use are, first, the disease is thought to be reversible, second, the child will survive with an acceptable quality of life and, third, the child has an 80% chance of dying without ECMO. Seven of eighteen children receiving ECMO have survived to leave hospital, and all are functionally normal: these results are similar to international results. It would appear that ECMO is a useful therapy for some children with otherwise fatal cardiorespiratory failure.