UK experience in neonatal extracorporeal membrane oxygenation.

Pearson, Gale; Field, DavidJ.; Firmin, Richard K.; Sosnowski, Andrzej

doi:10.1136/adc.67.7_spec_no.822

Cited by 11 publications

(3 citation statements)

References 12 publications

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“…Most likely, a complex interplay amongst different factors associated with the underlying disease (pharmacological), treatment and “iatrogenesis,” further complicated by the child's genetic predisposition (5) and social economic status (6), determines a child's neurodevelopment. Emerging evidence seems to suggest that long-term neuropsychological deficits following neonatal critical illness are not associated with the type of treatment, such as extracorporeal membrane oxygenation (ECMO) (7), but rather with underlying disease processes, such as hypoxia-ischemia, stress, and neuroinflammation (2, 8, 9). However, whether this is similar between neonates with severe respiratory failure and neonates with cardiac anomalies remains largely unknown.…”

Section: Introductionmentioning

confidence: 99%

Neurocognitive Outcome After Treatment With(out) ECMO for Neonatal Critical Respiratory or Cardiac Failure

Schiller

Tibboel

2019

Front. Pediatr.

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Over the years, it has become clear that children growing up after neonatal critical illness are at high risk of long-term neurocognitive deficits that impact their school performance and daily life activities. Although the pathophysiological mechanisms remain largely unknown, emerging evidence seems to suggest that long-term neuropsychological deficits following neonatal critical illness are not associated with the type of treatment, such as extracorporeal membrane oxygenation (ECMO), but rather with underlying disease processes. In this review, neurocognitive outcome and brain pathology following neonatal critical respiratory and cardiac illness, either treated with or without ECMO, are described and compared in order to gain insight into potential underlying pathophysiological mechanisms. Putting these findings together, it becomes apparent that both children with complex congenital heart disease and children who survived severe respiratory failure are at risk of neurocognitive deficits later in life. Neurorehabilitation strategies, such as Cogmed working-memory training, are discussed. While prevention of neurocognitive deficits altogether should be strived for in the future, this is not realistic at this moment. It is therefore of great importance that children growing up after neonatal critical illness receive long-term care that includes psychoeducation and personalized practical tools that can be used to improve their daily life activities.

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Section: Introductionmentioning

confidence: 99%

Neurocognitive Outcome After Treatment With(out) ECMO for Neonatal Critical Respiratory or Cardiac Failure

Schiller

Tibboel

2019

Front. Pediatr.

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“…Extracorporeal membrane oxygenation (ECMO) and extracorporeal carbon dioxide removal (ECC0 2 R) have been adopted as means of strong respiratory support. (1)(2)(3) Conventional extracorporeal support systems require high blood flow rates in the extracorporeal circuits to achieve optimal oxygenation or carbon dioxide (C0 2 ) elimination. (3,4) Common complications during long term extracorporeallife support with full flows are hemodynamic lability, anticoagulation related bleeding problems and infections.…”

Section: Figurementioning

confidence: 99%

Low Flow Veno-Venous ECMO: An Experimental Study

Calderón,

Verdín,

Galván

et al. 1994

J Extra Corpor Technol

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Clinical use of extracorporeal membrane oxygenation (ECMO) and carbon dioxide removal (ECCO2R) have become well established techniques for the treatment of severe respiratory failure; however they require full cardiopulmonary bypass, representing major procedures with high morbidity. We theorized the possibility of an efficient low flow venavenous extracorporeal membrane gas exchange method. Four mongrel 12kg dogs were submitted to vena-venous extracorporeal membrane gas exchange via a jugular dialysis catheter using a low flow (10 ml/min) roller pump and a membrane oxygenator for a period of four hours. Respiratory rate was set at 4 breaths/min with a FiO2 of 21% and ventilatory dead space was increased. Adequate gas exchange was obtained (pO2 139, pCO2 24, Sat 99.4%), without major hemodynamic changes or hematuria. Our results demonstrate the feasibility of a low flow, less aggressive system. Further research should be considered.

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“…Bartlett et al, however, and then other groups, were able to show the effectiveness of ECMO for neonatal respiratory failure.4 5 By 1985 ECMO had become the standard treatment for severe neonatal respiratory failure in the USA and initial UK experience in neonates is encouraging. 6 ECMO has been used less often for respiratory failure in older children. We report our early experience of ECMO in this age group.…”

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confidence: 99%