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Published on: October 24, 2018
Progress in pediatric extracorporeal membrane oxygenation
1Department of Pediatrics, State University of New York, Buffalo.
Insights
Extracorporeal membrane oxygenation (ECMO) provides life support for infants and children with severe heart or lung disease, allowing organs to rest and heal. Clinical interest is growing due to refined practices, not just technology.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary support technologies
Background:
- Life-threatening infant and child diseases necessitate advanced circulatory and respiratory support.
- Extracorporeal membrane oxygenation (ECMO) offers prolonged physiological support, enabling organ rest.
Purpose of the Study:
- To explain the growing clinical interest in ECMO for pediatric critical care.
- To highlight the role of clinical practice refinement in ECMO application.
Main Methods:
- Review of clinical practices and technological advancements in ECMO.
- Analysis of ECMO application in new pediatric patient populations.
Main Results:
- ECMO facilitates recovery by breaking cycles of organ injury and dysfunction.
- Technological advances are secondary to clinical practice improvements in driving ECMO's growth.
- ECMO application has expanded to diverse pediatric patient groups.
Conclusions:
- ECMO is a vital tool for potentially reversible pediatric cardiopulmonary failure.
- The effectiveness of ECMO stems from enabling organ recuperation through rest.
- The application of ECMO, rather than the technology itself, is considered experimental.
Abstract:
Prolonged complete support of the circulation and of gas exchange can be achieved by extracorporeal membrane oxygenation (ECMO) in infants and children with potentially reversible, albeit life-threatening, disease. This allows lung rest or cardiac rest at times when dependence in those organs would be physiologically expensive. Although ECMO has no intrinsic healing powers, pediatric hearts and lungs exhibit tremendous recuperative power once the cycle of injury, inefficient performance, abuse, and secondary injury can be broken. Recent advances in technology, although impressive, do not explain the rapid growth of clinical interest in ECMO. Most recent progress in ECMO derives from refinement of clinical practices and the application of this technology to new patient populations. ECMO is not itself an experiment. It is the application of ECMO that is experimental.
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