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Pediatric Extracorporeal Life Support Using a Third Generation Diagonal Pump.

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This summary is machine-generated.

The Medos Deltastream diagonal-pump (DP3) effectively supports pediatric patients needing cardiac or pulmonary extracorporeal assistance. This versatile pump demonstrated high survival rates and adaptability for various support methods in a single-center study.

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Area of Science:

  • Cardiovascular Surgery
  • Pediatric Critical Care
  • Extracorporeal Life Support

Background:

  • Extracorporeal support is vital for pediatric patients with severe cardiac or pulmonary failure.
  • The Medos Deltastream diagonal-pump (DP3) is a device used for extracorporeal membrane oxygenation (ECMO) and ventricular assist.
  • Evaluating the DP3's performance in a pediatric cohort is crucial for understanding its efficacy and safety.

Purpose of the Study:

  • To assess the single-center experience with the Medos Deltastream diagonal-pump (DP3) in pediatric patients.
  • To evaluate the pump's effectiveness for various extracorporeal support configurations, including cardiac and pulmonary assistance.
  • To determine survival rates and identify factors influencing outcomes in pediatric patients supported by the DP3.

Main Methods:

  • A retrospective analysis of 27 consecutive pediatric patients (28 runs) who received support from the DP3 between January 2013 and June 2014.
  • Patients received veno-arterial extracorporeal life support (ECLS), veno-venous ECMO, or ventricular assist devices (RVAD, LVAD, UNIVAD).
  • Cannulation approaches included midline sternotomy and cervical routes; pump function and patient outcomes were meticulously recorded.

Main Results:

  • The DP3 was utilized for diverse support types, including ECLS (n=16), ECMO (n=5), and various ventricular assist devices (n=7).
  • Successful weaning rates were 89.3%, with 30-day survival at 85.7% and hospital survival at 71.4%.
  • One instance of irreversible pump damage occurred during de-airing; however, meticulous flow adjustments were key to successful support.

Conclusions:

  • The Medos Deltastream diagonal-pump (DP3) is a flexible and effective device for pediatric extracorporeal support, adaptable to individual patient needs.
  • High survival rates suggest the DP3 is a viable option for complex pediatric cases requiring cardiac or pulmonary assistance.
  • Careful management of pump flow is essential for optimizing outcomes in pediatric patients undergoing extracorporeal support with the DP3.