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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.
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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program.

Erin Cicalese1, Sarah Meisler1, Michael Kitchin1

  • 1Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.

Journal of Perinatal Medicine
|December 12, 2022
PubMed
Summary
This summary is machine-generated.

A dedicated Extracorporeal Membrane Oxygenation (ECMO) team improved patient selection and outcomes in a new pediatric ECMO program. This structured approach enhanced survival rates from 0% to 60% within three years.

Keywords:
cannulationextracorporeal membrane oxygenationmedical decision makingpediatric ECMO

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Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary support technologies

Background:

  • Establishing a new pediatric Extracorporeal Membrane Oxygenation (ECMO) program presents unique challenges in patient selection and management.
  • Low-volume centers require specific strategies to ensure safe and effective ECMO implementation.

Purpose of the Study:

  • To evaluate the effectiveness of a designated ECMO team in patient selection and outcomes.
  • To assess the impact of a structured approach on a low-volume pediatric ECMO program's initial three years of operation.

Main Methods:

  • Retrospective chart review of patients who received ECMO consultation from March 2015 to May 2018.
  • Analysis of clinical and demographic data for patients who received ECMO versus those who did not.
  • Description of the ECMO selection process and program initiation strategies.

Main Results:

  • Out of 69 consultations, 50 were potential candidates, with 19 (38%) placed on ECMO.
  • Significant differences observed in oxygenation parameters (SpO2, PaO2, OI, A-aDO2) and acid-base status (lactate, pH) between ECMO and non-ECMO groups.
  • Survival to discharge improved from 0% in 2015 to 60% in 2018, averaging 63% over the study period.

Conclusions:

  • A designated ECMO team enhances patient selection and management in low-volume pediatric centers.
  • Strict management protocols and team simulations contribute to provider confidence and optimal patient care.
  • The described program structure, processes, and outcomes offer a model for developing new pediatric ECMO services.