Pediatric Extracorporeal Life Support Organization Registry International Report 2016.
Ryan P. Barbaro,Matthew L. Paden,Yigit S. Guner,Lakshmi Raman,Lindsay M. Ryerson,Peta M. A. Alexander,Viviane G. Nasr,Melania M. Bembea,Peter Rycus,Ravi R. Thiagarajan +9 more
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TLDR
Adverse events including neurologic events were common during ECLS, a fact that underscores the opportunity and need to promote quality improvement work.Abstract:
The purpose of this report is to describe the international growth, outcomes, complications, and technology used in pediatric extracorporeal life support (ECLS) from 2009 to 2015 as reported by participating centers in the Extracorporeal Life Support Organization (ELSO). To date, there are 59,969 children who have received ECLS in the ELSO Registry; among those, 21,907 received ECLS since 2009 with an overall survival to hospital discharge rate of 61%. In 2009, 2,409 ECLS cases were performed at 157 centers. By 2015, that number grew to 2,992 cases in 227 centers, reflecting a 24% increase in patients and 55% growth in centers. ECLS delivered to neonates (0-28 days) for respiratory support was the largest subcategory of ECLS among children <18-years old. Overall, 48% of ECLS was delivered for respiratory support and 52% was for cardiac support or extracorporeal life support to support cardiopulmonary resuscitation (ECPR). During the study period, over half of children were supported on ECLS with centrifugal pumps (51%) and polymethylpentene oxygenators (52%). Adverse events including neurologic events were common during ECLS, a fact that underscores the opportunity and need to promote quality improvement work.read more
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Acute Kidney Injury, Fluid Overload, and Outcomes in Children Supported With Extracorporeal Membrane Oxygenation for a Respiratory Indication.
Palen P. Mallory,David T. Selewski,David J. Askenazi,David S. Cooper,Geoffrey M. Fleming,Matthew L. Paden,Laura Murphy,Rashmi D Sahay,Eileen King,Michael Zappitelli,Brian C. Bridges +10 more
TL;DR: In this patient population, AKI and FO are associated with increased mortality and should be considered targets for medical interventions including judicious fluid management, diuretic use, and renal replacement therapy.
Journal ArticleDOI
Long-term survival and costs following extracorporeal membrane oxygenation in critically ill children—a population-based cohort study
Shannon M. Fernando,Danial Qureshi,Danial Qureshi,Peter Tanuseputro,Sonny Dhanani,Sonny Dhanani,Anne-Marie Guerguerian,Sam D. Shemie,Sam D. Shemie,Robert Talarico,Eddy Fan,Eddy Fan,Laveena Munshi,Bram Rochwerg,Damon C. Scales,Daniel Brodie,Kednapa Thavorn,Kednapa Thavorn,Kednapa Thavorn,Kwadwo Kyeremanteng +19 more
TL;DR: Children requiring ECMO continue to have a significant in-hospital mortality, but reassuringly, there is little decrease in long-term survival at 1 year, and total patient costs in the first year following ECMO were substantial.
Journal ArticleDOI
Outcomes of pediatric patients with oncologic disease or following hematopoietic stem cell transplant supported on extracorporeal membrane oxygenation: The PEDECOR experience.
Diana Steppan,Ryan D. Coleman,Heather K. Viamonte,Sheila J. Hanson,Megan K. Carroll,Orly R. Klein,Kenneth R. Cooke,Philip C. Spinella,Marie E. Steiner,Laura Loftis,Melania M. Bembea +10 more
TL;DR: Outcomes for patients with oncologic disease and/or after hematopoietic stem cell transplant requiring intensive care unit admission have improved, but indications for and outcomes after extracorporeal membrane oxygenation support in this population are poorly characterized.
Journal ArticleDOI
Anticoagulation in neonatal ECMO.
TL;DR: The hemostatic alterations that occur during ECMO are reviewed with a focus on current approaches and limitations to anticoagulation titration in neonates on ECMO.
Journal ArticleDOI
Pediatric ECMO Research: The Case for Collaboration.
TL;DR: This review discusses methodological challenges including heterogeneity of ages and diagnoses in the pediatric ECMO population, rapid advances in technology and clinical practice related to ECMO, feasibility of enrolling critically ill children on ECMO in clinical research studies, and variability in ECMO management across institutions and countries.
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