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Pediatric ECMO for pulmonary support: experience from 12 cases
H Ehrén1, K Palmér, M Eriksson
1Department of Pediatric Surgery, Karolinska Institute, St. Göran's Hospital, Stockholm, Sweden.
Insights
Extracorporeal membrane oxygenation (ECMO) offers a life-saving option for severe pediatric lung failure. This study shows high survival rates and minimal long-term issues in non-neonatal patients, suggesting wider consideration of ECMO therapy.
Area of Science:
- Pediatric Critical Care Medicine
- Cardiopulmonary Support Technologies
Background:
- Extracorporeal membrane oxygenation (ECMO) is a vital treatment for life-threatening but reversible lung failure.
- While well-established in neonates, ECMO application in non-neonatal pediatric patients is less documented.
Observation:
- This report details initial results from 12 non-neonatal pediatric cases treated with ECMO.
- The study focuses on survival rates, morbidity, and long-term outcomes.
Findings:
- A high survival rate of 75% (9 out of 12 patients) was achieved, with 8 of those patients being long-term survivors.
- Patients weaned from ECMO experienced a median of 4 days on mechanical ventilation post-treatment.
- All long-term survivors showed no neurological or pulmonary sequelae at follow-up.
Implications:
- These findings suggest ECMO is a safe and effective therapy for severe pediatric respiratory failure.
- ECMO should be more frequently considered for non-neonatal pediatric patients with potentially reversible pulmonary failure.
- The low morbidity observed supports ECMO as a viable option to bridge patients to recovery.
Abstract:
Extracorporeal membrane oxygenation (ECMO), which can be described as treatment with a modified heart-lung machine over a prolonged period of time, is used to support patients with life-threatening but potentially reversible lung failure. ECMO by itself does not cure the patient but gives the lungs a chance to rest while awaiting spontaneous or therapeutic healing. The method is well documented in the neonatal age group. In the non-neonatal age group, however, experience is less extensive. This report of the initial result from our hospital with 12 non-neonatal pediatric cases shows high survival and low morbidity. Nine of the 12 patients were able to be weaned from ECMO (75% survival) and 8 of these 9 patients were long-term survivors. Medium time on the ventilator after discontinuation of ECMO was 4 days. At follow-up, all long-term survivors had no signs of neurological or pulmonary sequelae. These encouraging results point to the fact that ECMO should be considered more often in cases of life-threatening but potentially reversible pulmonary failure.