Related Experiment Videos

Outcomes in children with refractory pneumonia supported with extracorporeal membrane oxygenation

Nathan Smalley1, Graeme MacLaren, Derek Best

  • 1Paediatric Intensive Care Unit, Royal Children's Hospital, Melbourne, Australia. nathansmalley@me.com

Intensive Care Medicine
|May 1, 2012
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) for severe pediatric pneumonia has improved survival rates to 90% in recent years. Key factors impacting survival include circuit changes and continuous renal replacement therapy.

Area of Science:

  • Pediatric Critical Care Medicine
  • Respiratory Medicine
  • Cardiopulmonary Support

Background:

  • Severe pediatric pneumonia presents a significant challenge in intensive care settings.
  • Extracorporeal membrane oxygenation (ECMO) is a vital life support modality for critically ill children.
  • Understanding factors influencing ECMO efficacy in pneumonia is crucial for improving outcomes.

Purpose of the Study:

  • To review the utilization of ECMO in severe pediatric pneumonia.
  • To evaluate factors affecting the efficacy of ECMO treatment for this condition.

Main Methods:

  • A retrospective analysis of a tertiary pediatric intensive care unit's ECMO database.
  • Chart review of patients treated with ECMO for severe pneumonia over 23 years.
  • Comparison of outcomes based on pneumonia type, ECMO configuration, acquisition, and time period.

Main Results:

  • Fifty patients (52 cases) with severe pneumonia were treated with ECMO.
  • Community-acquired pneumonia cases exhibited higher illness severity.
  • Survival rates improved significantly after 2005, reaching 88.2%.

Conclusions:

  • Pediatric survival for pneumonia requiring ECMO has improved, now approaching 90%.
  • Performing ECMO circuit changes and utilizing continuous renal replacement therapy are associated with increased mortality risk.
  • Optimizing ECMO management strategies can further enhance survival in severe pediatric pneumonia.
Abstract

Related Concept Videos

Pneumonia IV: Management01:28

Pneumonia IV: Management

The treatment of pneumonia varies based on its severity and the causative pathogen. Here is a structured approach to managing pneumonia, integrating pharmaceutical and supportive care strategies.
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
Pneumonia III: Complications and Assessment01:30

Pneumonia III: Complications and Assessment

Pneumonia poses the potential for numerous complications that warrant consideration. These complications include the following:
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
Respiratory Assessment: Purpose and Indications01:19

Respiratory Assessment: Purpose and Indications

Respiratory assessment is a cornerstone of nursing assessments, crucial for the early detection of patient deterioration. This evaluation transcends routine procedures, representing a critical skill nurses must master to ensure optimal patient care.
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...