Mechanical circulatory support in paediatric population

Abstract

Extra-corporeal membrane oxygenation is a life-saving modality to support the cardiac and/or pulmonary system as a form of life support in resuscitation, post-cardiotomy, as a bridge to cardiac transplantation and in respiratory failure. Its use in the paediatric and neonatal population has proven incredibly useful. However, extra-corporeal membrane oxygenation is also associated with a greater rate of mortality and complications, particularly in those with co-morbidities. As a result, interventions such as ventricular assist devices have been trialled in these patients. In this review, we provide a comprehensive analysis of the current literature on extra-corporeal membrane oxygenation for cardiac support in the paediatric and neonatal population. We evaluate its effectiveness in comparison to other forms of mechanical circulatory support and focus on areas for future development.

Rewarming Young Children After Drowning-Associated Hypothermia and Out-of-Hospital Cardiac Arrest: Analysis Using the CAse REport Guideline

“…One reason may be that bleeding and thrombosis rates are higher in pediatric ECMO than the corresponding rates in adults ( 32 , 33 ). There is also evidence that a significant percentage of children experience clinically relevant episodes of sepsis (limb and bowel) ischemia, liver dysfunction, renal failure, and/or device malfunctioning during ECMO ( 34 ). Furthermore, ethical aspects of “consent procedure,” “initiation,” “discontinuation” ( 35 ), and “clinical efficacy” ( 30 ) remain largely uninvestigated in children.…”