Pediatric Extracorporeal Membrane Oxygenation

Christopher Loren Jenks; Lakshmi Raman; Heidi J Dalton

doi:10.1016/j.ccc.2017.06.005

Pediatric Extracorporeal Membrane Oxygenation

Crit Care Clin. 2017 Oct;33(4):825-841. doi: 10.1016/j.ccc.2017.06.005. Epub 2017 Jul 29.

Authors

Christopher Loren Jenks¹, Lakshmi Raman², Heidi J Dalton³

Affiliations

¹ Department of Pediatrics, Section Critical Care Medicine, Cardiac Intensive Care Unit, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA.
² Department of Pediatrics, Section Critical Care Medicine, University of Texas Southwestern Medical Center at Dallas, Children's Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
³ Department of Pediatrics, Adult and Pediatric ECMO, INOVA Fairfax Medical Center, Inova Fairfax Hospital, 3300 Gallows Road, Falls Church, VA 22042, USA; George Washington University, 2121 I Street Northwest, Washington, DC 20052, USA. Electronic address: Heidi.dalton26@gmail.com.

PMID: 28887930
DOI: 10.1016/j.ccc.2017.06.005

Abstract

Extracorporeal life support is a modified form of cardiopulmonary bypass. Experience in extracorporeal membrane oxygenation (ECMO) has come largely from the neonatal population. Most centers have transitioned the ECMO pumps from roller pumps to centrifugal technology. Modes of support include venovenous for respiratory support and venoarterial for cardiac support. "Awake" ECMO is the trend with extubation and tracheostomy on the rise. Fluid overload is common and managed with diuretics or hemofiltration. Nutrition is important and provided enterally or via total parenteral nutrition. Overall survival for pediatric cardiac and respiratory ECMO has remained at approximately 50% to 60%.

Keywords: Centrifugal technology; Fluid overload; Nutrition; Pediatric extracorporeal life support; Pediatric extracorporeal membrane oxygenation.

Publication types

Review

MeSH terms

Cardiopulmonary Bypass
Child
Extracorporeal Membrane Oxygenation / adverse effects
Extracorporeal Membrane Oxygenation / methods*
Extracorporeal Membrane Oxygenation / mortality
Extracorporeal Membrane Oxygenation / trends*
Humans
Infant, Newborn
Survival Rate