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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse
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Veno-Venous Extracorporeal Membrane Oxygenation in a Mouse

Published on: October 24, 2018

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Extracorporeal membrane oxygenation support in pediatrics

Tugba Erdil1,2, Frithjof Lemme1,2, Alexander Konetzka1,2

  • 1Pediatric Cardiovascular Surgery, Pediatric Heart Center, Department of Surgery, University Children's Hospital Zurich, Zurich, Switzerland.

Annals of Cardiothoracic Surgery
|March 12, 2019
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) provides vital heart and lung support for neonates, children, and adults. This review details pediatric ECMO indications, circuits, cannulation strategies, and institutional experience, including extracorporeal cardiopulmonary resuscitation (eCPR).

Area of Science:

  • Cardiovascular Sciences
  • Pediatric Critical Care
  • Respiratory Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) is increasingly utilized globally for heart and/or lung support in neonates, children, and adults.
  • Favorable outcomes and reduced contraindications are driving the worldwide expansion of ECMO applications.
  • Pediatric ECMO indications, circuit configurations, and cannulation techniques are distinct from adult protocols and require tailored approaches.

Discussion:

  • This review synthesizes current clinical indications for ECMO across different age groups.
  • It explores various ECMO circuit designs and cannulation strategies, emphasizing pediatric-specific considerations.
  • The article presents institutional data from 92 pediatric ECMO cases (34 neonates, 58 children) managed between 2014-2018, noting a predominant 80% veno-arterial placement rate.

Key Insights:

  • ECMO offers crucial short- or long-term cardiopulmonary support.
  • Individualized ECMO circuits and cannulation are essential, particularly in pediatric patients.
  • The study highlights the application of ECMO in cardiac arrest scenarios, termed extracorporeal cardiopulmonary resuscitation (eCPR).

Outlook:

  • Further research into optimizing ECMO circuits and cannulation strategies for pediatric populations is warranted.
  • Expanding the use of ECMO, including eCPR, may improve outcomes in critically ill pediatric patients.
  • Continued evaluation of long-term results and refinement of ECMO protocols will enhance its role in critical care.

Keywords:
Extracorporeal membrane oxygenation (ECMO)extracorporeal cardiopulmonary resuscitation (eCPR)pediatrics

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