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Pediatric and neonatal extracorporeal life support: current state and continuing evolution

Brian P Fallon1, Samir K Gadepalli2, Ronald B Hirschl2

  • 1Department of Surgery, ECLS Laboratory, B560 MSRB II/SPC 5686, Michigan Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA. bfallon@med.umich.edu.

Pediatric Surgery International
|January 2, 2021
PubMed

Insights

Extracorporeal life support (ECLS) is increasingly used in pediatric and neonatal patients. Technological advancements have expanded ECLS applications, indications, and management strategies for improved patient outcomes.

Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary support technologies
  • Neonatal intensive care

Background:

  • Extracorporeal life support (ECLS) use in pediatric and neonatal populations is rising.
  • Significant advancements in ECLS technology and safety have broadened its applicability.
  • The evolving landscape necessitates updated clinical understanding and practice.

Purpose of the Study:

  • To review the current state of pediatric and neonatal ECLS.
  • To discuss advancements in ECLS technology, indications, and management.
  • To provide an overview of modern ECLS patient care.

Main Methods:

  • Review of current literature and technological advancements in ECLS.
  • Analysis of expanding indications and decreasing contraindications for ECLS.
  • Description of traditional and hybrid cannulation techniques.
  • Examination of updated circuit components and management protocols.

Main Results:

  • ECLS technology and safety have improved, expanding its use.
  • Indications for ECLS are broadening, while contraindications are narrowing.
  • Innovations include hybrid cannulation, improved circuit components, and advanced patient management.

Conclusions:

  • Modern ECLS offers expanded therapeutic options for critically ill pediatric and neonatal patients.
  • Continuous technological innovation and refined management protocols are key to optimizing ECLS outcomes.
  • A comprehensive approach to ECLS, encompassing technical and clinical aspects, is essential.

Keywords:
Extracorporeal life support (ECLS)Extracorporeal membrane oxygenation (ECMO)NeonatalPediatricRespiratory failure

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