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Compression Device-Assisted Extracorporeal Cardiopulmonary Resuscitation Cannulation in Pediatric Patients-A

Syed Murfad Peer1, Syed Bukhari1, Manan Desai1

  • 1Department of Cardiovascular Surgery, 8404Children's National Hospital, Washington, DC, USA.

World Journal for Pediatric & Congenital Heart Surgery
|April 21, 2022
PubMed
Summary

Automated chest compression devices may enable uninterrupted chest compressions during pediatric extracorporeal cardiopulmonary resuscitation (ECPR) cannulation. This simulation study demonstrated successful neck ECPR cannulation without pausing compressions, potentially reducing neurological injury.

Keywords:
assisted chest compression in pediatric patientspediatric cardiac arrestpediatric extracorporeal cardiopulmonary resuscitation

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Area of Science:

  • Pediatric Critical Care
  • Cardiovascular Surgery
  • Biomedical Engineering

Background:

  • Pediatric extracorporeal cardiopulmonary resuscitation (ECPR) neck cannulation typically requires interrupting chest compressions.
  • Interruptions in cardiopulmonary resuscitation (CPR) increase the risk of neurological injury in pediatric patients.
  • Automated chest compression devices offer a potential solution for maintaining continuous CPR.

Purpose of the Study:

  • To evaluate the feasibility of using an automated chest compression device during pediatric ECPR neck cannulation.
  • To assess if uninterrupted chest compressions can be maintained during simulated surgical cannulation of infant neck vessels.

Main Methods:

  • A prototype pediatric automated chest compression device was used on an infant CPR manikin.
  • Simulated surgical exploration and cannulation of the infant's right carotid artery and right internal jugular vein were performed.
  • CPR effectiveness was monitored using a feedback device during the simulations.

Main Results:

  • Four simulations of pediatric ECPR neck cannulation were successfully completed.
  • All cannulations were performed using the automated device without interrupting chest compressions.
  • Both vessel-sparing and non-vessel-sparing techniques were successfully simulated.

Conclusions:

  • Automated chest compression devices can facilitate uninterrupted chest compressions during simulated pediatric ECPR neck cannulation.
  • This approach may reduce neurological complications associated with ECPR.
  • Further research is warranted to validate this technique in clinical settings.