Related Experiment Video

Updated: Aug 24, 2025

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
04:55

Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model

Published on: May 26, 2023

856

Extracorporeal membrane oxygenation and paediatric palliative care in an ICU

Claudia Delgado-Corcoran1,2, Sarah E Wawrzynski3,4, Brian Flaherty1

  • 1Division of Critical Care, Department of Pediatrics, University of Utah, 295 Chipeta Way, PO BOX 581289, Salt Lake City, UT, USA.

Cardiology in the Young
|October 24, 2022
PubMed

Insights

Palliative care consultation for children on extracorporeal membrane oxygenation was infrequent, often occurring late in their hospital stay. Early palliative care integration is crucial for improving outcomes for these critically ill children and their families.

Area of Science:

  • Pediatric Critical Care Medicine
  • Palliative Care
  • Extracorporeal Membrane Oxygenation (ECMO)

Background:

  • Extracorporeal membrane oxygenation (ECMO) provides life support for critically ill children with severe cardiorespiratory failure.
  • Palliative care consultation aims to improve quality of life for patients with serious illnesses and their families.
  • Integrating palliative care early in critical illness management can enhance patient and family support.

Purpose of the Study:

  • To compare the rates, clinical characteristics, and outcomes of pediatric palliative care consultations in children supported by ECMO.
  • To identify patterns and timing of palliative care consultations during ECMO support.
  • To assess the impact of palliative care consultation on clinical outcomes and resource utilization.

Main Methods:

  • Retrospective review of clinical data for children (0-21 years) on ECMO from January 2017 to December 2019.
  • Comparison of outcomes between children who received palliative care consultation and those who did not.
  • Analysis of disease severity, length of stay, use of life-sustaining therapies, and mortality.

Main Results:

  • Only 19% of 100 ECMO patients received palliative care consultation, typically initiated late in the hospital course (median 27 days post-cannulation).
  • Consulted children had higher disease severity, longer hospital stays (92 vs. 19 days), and increased use of life-sustaining therapies post-decannulation (79% vs. 23%).
  • Most deaths (84%) occurred during ECMO hospitalization, regardless of consultation status.

Conclusions:

  • Palliative care consultation for ECMO patients was rare and often considered a late intervention, indicating missed opportunities for early integration.
  • The findings suggest palliative care was not viewed as an acute need, leading to delayed involvement.
  • Earlier and more frequent palliative care engagement is recommended for ECMO patients and their families to improve care throughout the clinical course.
Abstract

Keywords:
Extracorporeal membrane oxygenationPalliative carebereavementlongitudinal supportpaediatricssurvivors and non-survivors

More Related Videos

Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death09:54

Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death

Published on: August 15, 2022

1.9K
Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

412

Related Concept Videos

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen01:16

Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen

Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
866
Acute Respiratory Failure-II01:21

Acute Respiratory Failure-II

Type I Respiratory Failure, or hypoxemic respiratory failure, occurs when the partial pressure of oxygen (PaO2) in arterial blood falls below 60 mmHg while breathing room air without a corresponding increase in arterial carbon dioxide levels (PaCO2). This condition highlights a significant impairment in the lungs' capacity to oxygenate the blood.
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
319
Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without...
273
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
192
Acute Respiratory Failure-V01:29

Acute Respiratory Failure-V

The treatment for acute respiratory failure varies based on factors like the underlying cause, overall health, and severity. A collaborative healthcare team is essential for early detection, often through arterial blood gas analysis. Identifying the cause is the primary goal, with treatment strategies adjusted for ventilation/perfusion (V/Q) mismatch, shunting, or diffusion impairment.
Ensure that patients are monitored continuously for their response to therapy, including changes in...
183
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
287