Extracorporeal membrane oxygenation as a lifesaving modality in the treatment of pediatric patients with burns and respiratory failure

Askegard-Giesmann, Johanna R.; Besner, Gail E.; Fabia, Renata; Caniano, Donna A.; Preston, Thomas J.; Kenney, Brian D.

doi:10.1016/j.jpedsurg.2010.02.106

Cited by 36 publications

(18 citation statements)

References 18 publications

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“…[30] In addition, small studies have shown a survival benefit to the use of extracorporeal membrane oxygenation (ECMO) in these patients if they have failed maximal ventilator therapy. [31] Despite the progress in using advanced ventilator strategies for managing refractory hypoxia in these patients, there is unfortunately a lack of consensus amongst major burn centers as to which therapy is the best, with wide variability in practice being noted. [32]…”

Section: Management Of Inhalational Injury and Respiratory Failurementioning

confidence: 99%

Pediatric burn injuries

Krishnamoorthy

Ramaiah

Bhananker

2012

Int J Crit Illn Inj Sci

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Pediatric burns comprise a major mechanism of injury, affecting millions of children worldwide, with causes including scald injury, fire injury, and child abuse. Burn injuries tend to be classified based on the total body surface area involved and the depth of injury. Large burn injuries have multisystemic manifestations, including injuries to all major organ systems, requiring close supportive and therapeutic measures. Management of burn injuries requires intensive medical therapy for multi-organ dysfunction/failure, and aggressive surgical therapy to prevent sepsis and secondary complications. In addition, pain management throughout this period is vital. Specialized burn centers, which care for these patients with multidisciplinary teams, may be the best places to treat children with major thermal injuries. This review highlights the major components of burn care, stressing the pathophysiologic consequences of burn injury, circulatory and respiratory care, surgical management, and pain management of these often critically ill patients.

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Section: Management Of Inhalational Injury and Respiratory Failurementioning

confidence: 99%

Pediatric burn injuries

Krishnamoorthy

Ramaiah

Bhananker

2012

Int J Crit Illn Inj Sci

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“…Each of these modalities has been effective in removing CO 2 and reducing PaCO 2 , and EMCO has been effective as a salvage modality in individual patients with severe ALI and ARDS. 67,68 Disappointingly, in a sheep model of inhalation injury, early use of the extracorporeal CO 2 removal device had no effect on severity of lung injury or mortality. 69 …”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Pathophysiology, research challenges, and clinical management of smoke inhalation injury

et al. 2016

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SummarySmoke inhalation injury is a serious medical problem that increases morbidity and mortality after severe burns. The National Repository of the American Burn Association houses data from 203,422 patients treated at 99 U.S. burn hospitals and centers between 2005 and 2014. These data show that the presence of smoke inhalation injury increases mortality (by nearly 24-fold) in burn patients under 60 years and in those with a total burned surface area between 0.1 and 19.9%.1 The incidence of smoke inhalation injury may increase exponentially in mass casualty, large-scale fires;2,3 14 (78%) of the 18 patients severely burned in the World Trade Center attack who were admitted to one burn center had inhalation injury.4 However, relatively little attention has been paid to this devastating condition, and the bulk of research is limited to preclinical basic science studies. This review discusses our current understanding of the pathophysiology of smoke inhalation injury, the best evidence-based treatments, and challenges and future directions in diagnostics and management.

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“…For the patients placed on high-frequency oscillatory ventilation, 7 survived. There were 7 patients who did not have information regarding the type of mechanical ventilation [ 69 ].…”

Section: Reviewmentioning

confidence: 99%