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Extracorporeal membrane oxygenation in pediatric respiratory failure secondary to smoke inhalation injury
M S Lessin1, S E el-Eid, M D Klein
1Department of Surgery, Wayne State University, Detroit, MI, USA.
Insights
Extracorporeal membrane oxygenation (ECMO) successfully treated respiratory failure in two children with severe smoke inhalation injuries. This life-saving therapy facilitated recovery, allowing both patients to be discharged breathing room air.
Area of Science:
- Pediatric critical care medicine
- Respiratory failure management
- Burn injury treatment
Background:
- Smoke inhalation injury frequently causes severe respiratory compromise in children.
- Respiratory failure in pediatric burn patients presents significant management challenges.
- Extracorporeal membrane oxygenation (ECMO) is a potential rescue therapy for refractory respiratory failure.
Abstract:
Extracorporeal membrane oxygenation (ECMO) was used successfully in two children who had respiratory failure secondary to smoke inhalation injury. The first involved a 20% body surface area burn with initial carboxyhemoglobin of 26%. The patient developed varicella pneumonia, which complicated his respiratory failure; he was placed on ECMO for 7 days. The second infant had a 35% body surface area burn and carboxyhemoglobin of 30%. He underwent debridement and allografting while on ECMO, and was decannulated after 13 days. Anticoagulation for ECMO did not significantly interfere with dressing changes. Both patients had definitive autografting and were discharged home breathing room air.