Use of Extracorporeal Membrane Oxygenation for Respiratory Failure in Term Infants

Kirkpatrick, Barry V.; Krummel, Thomas M.; Mueller, Dawn G.; Ormazabal, M; Greenfield, Lazar J.; Salzberg, A.M.; Crute, Stephen L.; Boswell, Peter A.

doi:10.1542/peds.72.6.872

Cited by 59 publications

(2 citation statements)

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“… 17 Furthermore, patients with sepsis often present with thrombocytopenia and abnormal coagulation function, while ECMO necessitates anticoagulation therapy, which can potentially worsen bleeding. 18 19 In Park et al ’s study, a total of 32 patients received ECMO support for RSS, only seven patients (21.9%) survived to hospital discharge. 20 In Huang et al ’s study, hospital survival rate was much lower (15%).…”

Section: Introductionmentioning

confidence: 93%

ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated (ECMO-RESCUE): study protocol for a prospective, multicentre, non-randomised cohort study

Chen,

Guo,

Kong

et al. 2024

BMJ Open

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IntroductionSevere septic cardiomyopathy (SCM) is one of the main causes of refractory septic shock (RSS), with a high mortality. The application of venoarterial extracorporeal membrane oxygenation (ECMO) to support the impaired cardiac function in patients with septic shock remains controversial. Moreover, no prospective studies have been taken to address whether venoarterial ECMO treatment could improve the outcome of patients with sepsis-induced cardiogenic shock. The objective of this study is to assess whether venoarterial ECMO treatment can improve the 30-day survival rate of patients with sepsis-induced refractory cardiogenic shock.Methods and analysisExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated is a prospective, multicentre, non-randomised, cohort study on the application of ECMO in SCM. At least 64 patients with SCM and RSS will be enrolled in an estimated ratio of 1:1.5. Participants taking venoarterial ECMO during the period of study are referred to as cohort 1, and patients receiving only conventional therapy without ECMO belong to cohort 2. The primary outcome is survival in a 30-day follow-up period. Other end points include survival to intensive care unit (ICU) discharge, hospital survival, 6-month survival, quality of life for long-term survival (EQ-5D score), successful rate of ECMO weaning, long-term survivors’ cardiac function, the number of days alive without continuous renal replacement therapy, mechanical ventilation and vasopressor, ICU and hospital length of stay, the rate of complications potentially related to ECMO treatment.Ethics and disseminationThe trial has been approved by the Clinical Research and Application Institutional Review Board of the Second Affiliated Hospital of Guangzhou Medical University (2020-hs-51). Participants will be screened and enrolled from ICU patients with septic shock by clinicians, with no public advertisement for recruitment. Results will be disseminated in research journals and through conference presentations.Trial registration numberNCT05184296.

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Section: Introductionmentioning

confidence: 93%

ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated (ECMO-RESCUE): study protocol for a prospective, multicentre, non-randomised cohort study

Chen,

Guo,

Kong

et al. 2024

BMJ Open

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“…Without the continued effort of Dr. Bartlett et al, ECMO may have ended as an anecdote in medical history. Dr. Bartlett and his research team continued to focus their efforts on neonatal patients with respiratory distress syndrome showing improved survival in patients supported with ECMO compared to conventional ventilation therapies [ 7 , 9 ]. Bartlett and his group performed a prospective randomized trial of ECMO vs. conventional therapy for severe neonatal respiratory distress syndrome.…”

Section: Veno-arterial Ecmomentioning

confidence: 99%

Advances in Extracorporeal Support Technologies in Critically Ill Children

2023

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The field of pediatric heart failure is evolving, and the patient population is growing as survival after complex congenital heart surgeries is improving. Mechanical circulatory support and extracorporeal respiratory support in critically ill children has progressed to a mainstay rescue modality in pediatric intensive care medicine. The need for mechanical circulatory support is growing, since the number of organ donors does not meet the necessity. This article aims to review the current state of available mechanical circulatory and respiratory support systems in acute care pediatrics, with an emphasis on the literature discussing the challenges associated with these complex support modalities.

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Predicting survival in infants with persistent pulmonary hypertension of the newborn

Davis¹,

Spitzer²,

Cox³

et al. 1988

Pediatric Pulmonology

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Since persistent pulmonary hypertension of the newborn (PPHN) often occurs as a life-threatening illness, it would be advantageous to identify the highest-risk infants within the first 24 hours of life so that transfer to centers with extracorporeal membrane oxygenation (ECMO) or high-frequency ventilation can be facilitated. Fifty-three infants with PPHN were evaluated retrospectively. A multivariate discriminant analysis of risk factors determined that lowest pH, critical PaCO2, highest inspiratory pressure (PI), maximum ventilator rate, and 5-minute Apgar score were significantly different between the 35 survivors (66%) and the 18 infants (34%) who had died when examined within the first 24 hours of life. A clinical scoring system was designed based on these five criteria, which predicted outcome accurately in 93% of infants. A logistic regression analysis was performed as a check on these results and found that lowest pH, critical PaCO2, and PI predicted outcome with great accuracy. These results suggest that the use of these scoring systems within the first 24 hours of age may help predict outcome in infants with PPHN.

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Use of Extracorporeal Membrane Oxygenation for Respiratory Failure in Term Infants

Cited by 59 publications

References 0 publications

ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated (ECMO-RESCUE): study protocol for a prospective, multicentre, non-randomised cohort study

ExtraCorporeal Membrane Oxygenation in the therapy for REfractory Septic shock with Cardiac function Under Estimated (ECMO-RESCUE): study protocol for a prospective, multicentre, non-randomised cohort study

Advances in Extracorporeal Support Technologies in Critically Ill Children

Predicting survival in infants with persistent pulmonary hypertension of the newborn

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