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Pediatric Extracorporeal Life Support Organization Registry International Report 2016.

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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.

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2018 American Heart Association Focused Update on Pediatric Advanced Life Support: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

TL;DR: The writing group reaffirmed the 2015 pediatric advanced life support guideline recommendation that either lidocaine or amiodarone may be used to treat pediatric patients with shock-refractory ventricular fibrillation or pulseless ventricular tachycardia.
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Clinical controversies in anticoagulation monitoring and antithrombin supplementation for ECMO.

TL;DR: The authors discuss the complexities of anticoagulation monitoring and therapeutic intervention for patients on ECMO and examine the challenges surrounding AT supplementation given both the historical and current perspectives summarized in the literature on these topics.
Journal ArticleDOI

2021 ELSO Adult and Pediatric Anticoagulation Guidelines.

TL;DR: These guidelines are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing ECLS / ECMO and describe what are believed to be useful and safe practice for extracorporeal life support (ECLS, ECMO) as mentioned in this paper .
References
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Journal ArticleDOI

Acute Physiology and Chronic Health Evaluation (APACHE) IV: hospital mortality assessment for today's critically ill patients.

TL;DR: APACHE IV predictions of hospital mortality have good discrimination and calibration and should be useful for benchmarking performance in U.S. ICUs, and aggregate mortality was systematically overestimated as model age increased.
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PIM2: a revised version of the Paediatric Index of Mortality

TL;DR: PIM2 has been re-calibrated to reflect the improvement that has occurred in intensive care outcome and is therefore suitable for continuous monitoring of the quality of paediatric intensive care.
Journal ArticleDOI

Extracorporeal Life Support Organization Registry International Report 2016.

TL;DR: Extracorporeal life support use in the support of adults with respiratory and cardiac failure represented the largest growth in the recent time period and underscore the need for skilled ECLS management and appropriately trained ECLs personnel and teams.
Journal ArticleDOI

Validation of the paediatric logistic organ dysfunction (PELOD) score: prospective, observational, multicentre study

TL;DR: PELod and dPELOD scores are valid outcome measures of the severity of multiple organ dysfunction syndrome in paediatric intensive care units; their use should significantly reduce the sample size required to complete clinical trials in critically ill children.
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