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Extracorporeal Membrane Oxygenation in Critically Ill Children
Katherine Cashen1, Katherine Regling2, Arun Saini3
1Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children's Hospital, Durham, NC, USA; Duke University Medical Center, 2301 Erwin Road, Suite 5260Y, DUMC 3046, Durham, NC 27710, USA.
Pediatric Clinics of North America
|June 6, 2022
Summary
Extracorporeal membrane oxygenation (ECMO) has advanced significantly over 50 years. Despite technological improvements and wider use in critically ill children, overall survival rates for neonatal and pediatric ECMO have not improved.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary support technologies
- Neonatal intensive care
Background:
- Extracorporeal membrane oxygenation (ECMO) has seen 50 years of evolution.
- Technological, expertise, and application advancements have expanded ECMO use.
- Increased application in medically complex pediatric patients has not improved survival.
Purpose of the Study:
- To review the history, technology, and application of neonatal and pediatric ECMO.
- To analyze current indications, contraindications, management, and outcomes.
- To highlight recent advancements and future directions in ECMO.
Main Methods:
- Comprehensive literature review of ECMO history and development.
- Analysis of ECMO circuits, management protocols, and complication data.
- Examination of outcome data across various pediatric and neonatal populations.
Main Results:
- ECMO technology and application have expanded significantly over five decades.
- Despite increased experience and improved technology, overall survival has plateaued.
- Recent progress includes ECMO for unintubated patients and during the COVID-19 pandemic.
Conclusions:
- Neonatal and pediatric ECMO has evolved substantially but survival rates require further improvement.
- Continued research and innovation are crucial for enhancing ECMO outcomes.
- Emerging applications and strategies offer potential for future advancements in pediatric critical care.
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