Use of VA ECMO and percutaneous palliation of ductal dependent coarctation in a neonate with trisomy 21 and COVID-19 pneumonia

Sainathan, Sandeep; Heal, M. Elisabeth; Frantz, Elman G.; Johnston, P. G. B.; Smith, Rebecca L.; Sharma, Mahesh

doi:10.1007/s12055-021-01204-2

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…We identified 312 articles through the initial database search and the subsequent manual search. After removing 207 items based on the title and abstract, we reviewed the full text of 105 articles and included 44 studies (total number of ECMO use = 110) in the systematic review (8, 9, 11–14, 19–56). In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59).…”

Section: Resultsmentioning

confidence: 99%

“…In particular, three studies with relatively large sample sizes (number of ECMO use = 42, 31, and 69) were excluded because they did not provide clinical data of patients on ECMO separately (57–59). Of the 44 articles, 18 were retrospective observational studies (8, 9, 14, 19–33), four were case series (11–13, 34), and 22 were case reports (35–56). Among the total of 22 observational studies and case series, 10 studies included only one ECMO patient (12, 14, 27–34).…”

Section: Resultsmentioning

confidence: 99%

“…Among the 31 studies that reported the ECMO mode, 71% (56/79) received venoarterial-ECMO (8, 9, 11–13, 20, 21, 29, 32–41, 44–56). Thirty-four studies reported the ECMO duration; the median days were 7 (interquartile range, 5–13 d), with 71 days being the longest.…”

Section: Resultsmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Watanabe

Yasuhara

Karube

et al. 2022

Pediatric Critical Care Medicine

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OBJECTIVES: The indication, complications, and outcomes of extracorporeal membrane oxygenation (ECMO) in children with COVID-19–related illnesses remain unelucidated. Our study aimed to investigate the characteristics and outcomes of ECMO in children with COVID-19–related illnesses. DATA SOURCES: We searched PubMed and EMBASE databases in March 2022. STUDY SELECTION: We retrieved all studies involving children (age ≤ 18 yr) with COVID-19–related illnesses who received ECMO. DATA EXTRACTION: Two authors independently extracted data and assessed the risk of bias. Mortality, successful weaning rate, and complications while on ECMO were synthesized by a one-group meta-analysis using a random-effect model. Meta-regression was performed to explore the risk factors for mortality. DATA SYNTHESIS: We included 18 observational studies, four case series, and 22 case reports involving 110 children with COVID-19–related illnesses receiving ECMO. The median age was 8 years (range, 10 d to 18 yr), and the median body mass index was 21.4 kg/m 2 (range, 12.3–56.0 kg/m 2 ). The most common comorbidities were obesity (11% [7/63]) and congenital heart disease (11% [7/63]), whereas 48% (30/63) were previously healthy. The most common indications for ECMO were multisystem inflammatory syndrome in children (52% [47/90]) and severe acute respiratory distress syndrome (40% [36/90]). Seventy-one percent (56/79) received venoarterial-ECMO. The median ECMO runtime was 6 days (range, 3–51 d) for venoarterial ECMO and 11 days (range, 3–71 d) for venovenous ECMO. The mortality was 26.6% (95% CI, 15.9–40.9), and the successful weaning rate was 77.0% (95% CI, 55.4–90.1). Complications were seen in 37.0% (95% CI, 23.1–53.5) while on ECMO, including stroke, acute kidney injury, pulmonary edema, and thromboembolism. Corticosteroids and IV immunoglobulin therapies were associated with lower mortality. CONCLUSIONS: The mortality of children on ECMO for COVID-19 was relatively low. This invasive treatment can be considered as a treatment option for critically ill children with COVID-19.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Watanabe

Yasuhara

Karube

et al. 2022

Pediatric Critical Care Medicine

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“…At the time of this report, there have only been a few cases reported of neonates who were supported on ECMO for COVID-19. Both reported cases involved neonates with congenital heart disease, one pre-and the other post-op with only one of those neonates surviving to discharge (16,17). Compared to other published case reports, our patient had a more rapid progression from diagnosis to intubation and need for ECMO support, and he also had a longer duration of ECMO (18).…”

Section: Discussionmentioning

confidence: 57%

Extracorporeal membrane oxygenation in the care of a preterm infant with COVID-19 infection: Case report

Patrick-Esteve

Mumphrey

et al. 2022

Front. Pediatr.

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Coronavirus disease 2019 (COVID-19) was first reported to the World Health Organization (WHO) in December 2019 and has since unleashed a global pandemic, with over 518 million cases as of May 10, 2022. Neonates represent a very small proportion of those patients. Among reported cases of neonates with symptomatic COVID-19 infection, the rates of hospitalization remain low. Most reported cases in infants and neonates are community acquired with mild symptoms, most commonly fever, rhinorrhea and cough. Very few require intensive care or invasive support for acute infection. We present a case of a 2-month-old former 26-week gestation infant with a birthweight of 915 grams and diagnoses of mild bronchopulmonary dysplasia and a small ventricular septal defect who developed acute respiratory decompensation due to COVID-19 infection. He required veno-arterial extracorporeal membrane oxygenation support for 23 days. Complications included liver and renal dysfunction and a head ultrasound notable for lentriculostriate vasculopathy, extra-axial space enlargement and patchy periventricular echogenicity. The patient was successfully decannulated to conventional mechanical ventilation with subsequent extubation to non-invasive respiratory support. He was discharged home at 6 months of age with supplemental oxygen via nasal cannula and gastrostomy tube feedings. He continues to receive outpatient developmental follow-up. To our knowledge, this is the first case report of a preterm infant during their initial hospitalization to survive ECMO for COVID-19.

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“…(137) More studies are confirming our encouraging results that CoA stenting is effective and safe in selected small children with severe symptomatic CoA. (137)(138)(139)(140) For the future we should focus more on the long-term safety profile of alternative routes of vascular access (as percutaneous or surgical cutdown of the carotid artery) in VLBW infants. The other challenge is the inherent somatic aortic growth requiring subsequent intervention to remove or modify the stent.…”

Section: Interventions In Preterm Born Very Low Birth Weightsmentioning

confidence: 85%

Neonatal Cardiac Disease:

Stegeman¹

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Background and purpose Brain development is impaired in patients with severe congenital heart disease (CHD), although timing and degree of tissue-specific alterations remains unclear. Aim of this study was to compare intrauterine brain development between prospective cohorts of CHD and controls. Materials and methodsIn CHD and controls, fetal (gestational age 32-34 weeks) and/ or neonatal (term, first month after birth, preoperatively) 3T MRI-scans were segmented. Total brain volume (TBV), cortical (CGM) and deep grey matter (DGM), unmyelinated white matter (UWM), brainstem (BS), cerebellum (CB) volumes were calculated. Cortical development was assessed by inner cortical surface (iCS), cortical thickness (CT), and gyrification index (GI). Linear regression analysis was performed, with correction for postmenstrual age, gender, and birth weight. Linear mixed model analysis was used to assess brain growth. ResultsAt fetal MRI, BS volume was significantly smaller in CHD (n=21) than controls (n=25) (-15%; p<0.03). At neonatal MRI, TBV (-11%), CGM (-14%), UWM (-10%) and CB (-11%) volumes were significantly smaller in CHD (n=52) compared to controls (n=16) (all p<0.03). iCS (-16%), CT (-3%), and GI (-7%) were significantly smaller in neonatal CHD (p<0.01). Additionally, fetal to neonatal total brain (-11%; p<0.05) and CGM (-24%; p<0.01) volumetric growth rates were decreased in CHD (n=15) versus controls (n=15). Neonates with transposition of the great arteries (TGA, n=19) and single ventricle physiology (SVP, n=18) showed greater intrauterine delay in brain volumetric and cortical development than neonates with left ventricular outflow tract obstruction (n=13). ConclusionIntrauterine brain development is impaired in CHD, most pronounced in cortical growth, especially in TGA and SVP.

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Use of VA ECMO and percutaneous palliation of ductal dependent coarctation in a neonate with trisomy 21 and COVID-19 pneumonia

Cited by 6 publications

References 6 publications

Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Extracorporeal Membrane Oxygenation in Children With COVID-19: A Systematic Review and Meta-Analysis*

Extracorporeal membrane oxygenation in the care of a preterm infant with COVID-19 infection: Case report

Neonatal Cardiac Disease:

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