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Extracorporeal support in children with pediatric acute respiratory distress syndrome: proceedings from the Pediatric

Heidi J Dalton1, Duncan J Macrae,

  • 11Department of Child Health, University of Arizona College of Medicine-Phoenix, Phoenix, AZ. 2Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.

Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies
|June 3, 2015
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) offers critical support for pediatric acute respiratory distress syndrome. Consensus guidelines address its use, emphasizing reversible causes and quality of life, while highlighting the need for more data.

Area of Science:

  • Pediatric Critical Care Medicine
  • Extracorporeal Life Support
  • Pediatric Respiratory Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) has advanced significantly, offering prolonged cardiopulmonary support.
  • Pediatric acute respiratory distress syndrome (PARDS) presents complex management challenges.
  • Evidence-based guidelines are crucial for optimizing ECMO in pediatric critical care.

Framework:

  • A consensus conference of 27 pediatric acute lung injury experts convened over two years.
  • A modified Delphi approach was employed to reach agreement on recommendations.
  • The extracorporeal support subgroup included two international experts.

Implementation:

  • 151 recommendations for PARDS were developed, with 11 focusing on extracorporeal support.
  • 91% of recommendations achieved strong expert agreement.
  • Key recommendations cover ECMO for reversible causes, quality of life considerations, and data reporting to the Extracorporeal Life Support Organization registry.

Implications:

  • Consensus-driven guidelines provide initial direction for ECMO in PARDS.
  • Further research and data collection are needed to establish validated criteria for ECMO application and management.
  • Enhanced collaboration among investigators will refine optimal patient management protocols.
Abstract

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