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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
Published on: October 24, 2018
[Follow-up of survived children supported by extracorporeal membrane oxygenation]
1Pediatric Intensive Care Unit of Children's Hospital of Fudan University, Shanghai 201102, China.
Insights
Extracorporeal membrane oxygenation (ECMO) is safe for children, with most long-term issues stemming from their original conditions, not the treatment itself. Follow-up showed good recovery for most survivors.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiovascular Surgery
- Neonatal Medicine
Background:
- Venoarterial extracorporeal membrane oxygenation (ECMO) is a life-support measure for critically ill children when conventional therapies fail.
- The long-term outcomes and potential sequelae of ECMO in pediatric patients require thorough investigation.
Purpose of the Study:
- To evaluate the follow-up outcomes in children treated with venoarterial ECMO via internal carotid artery-vein incision.
- To assess neurological development, physical growth, quality of life, and personality in survivors.
Main Methods:
- Retrospective follow-up study of 10 pediatric patients treated with ECMO.
- Follow-up assessments included neurological examinations, developmental milestones, and quality of life evaluations.
- Data collected over a period of up to 2 years post-discharge.
Main Results:
- Five children experienced neurological issues, including abnormal EEG and mental retardation.
- Six children had sequelae related to their primary diseases, such as arrhythmia and abnormal pulmonary function.
- Most survivors showed normal physical development and cognitive function, with few adverse consequences attributed to ECMO.
Conclusions:
- Venoarterial ECMO treatment in children is associated with a good safety profile and minimal adverse effects.
- Long-term sequelae in survivors are predominantly linked to the severity of the primary underlying diseases.
- ECMO is a viable and safe option for pediatric patients with refractory cardiorespiratory failure.
Abstract:
Objective: To summarize the follow-up of children treated with venoarterial extracorporeal membrane oxygenation (ECMO) by incision of internal carotid artery-vein. Method: This was a retrospective study, 10 children in whom the conventional therapy failed, but survived after treatment with ECMO technique through right internal jugular artery-venous incision and ligation after ECMO in pediatric intensive care unit (PICU) of Fudan University were followed up from December 2011 to December 2015. Primary disease situation, neurological development, growth and development, quality of life and personality development were included. All children were followed up once every six months after discharge, and once a year after 2 years. The longest follow-up period was 2 years. Result: Of the 10 children 6 were boys and 4 girls, and ranged in age of onset from 1 day to 12 years . Five children had neurological problems, including abnormal brain CT (n=3), abnormal electroence phalogram (EEG) (n=3), and mental retardation (n=2). Three of those children had a history of hypoxia, 2 of whom accepted cardiopulmonary resuscitation. Eight children had normal brainstem evoked potential (BEAP) examinations. Primary diseases were all well controlled except for 6 children who had different degrees of sequelae, including mild arrhythmia (n=1), heart structure abnormality (n=2) and abnormal pulmonary function (n=3). The sequelae caused by the primary diseases were just embodied in examination. Their head circumference measurement and physical examination showed no obvious abnormalities, and blood biochemical tests, hemoglobin and blood gas analysis were also normal. One child's height was less than P3. The one who accepted cardiopulmonary resuscitation (CPR) at early stage of primary disease had trouble in daily life, presenting uncoordinated and unstable walking. One child was slightly bad tempered and asocial, and the rest were normal. Conclusion: The rest could take care of themselves. The ECMO sequelae of those survived children were mostly caused by primary diseases. ECMO treatment is safe and has less adverse consequences.
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