[Particularities of ECMO in Acute Respiratory Distress Syndrome in Pediatrics]

Overview

Journal Reanimation

Publisher Elsevier

Specialty Critical Care

Date 2020 Apr 15

PMID 32288736

Authors

S Renolleau

Affiliations

Soon will be listed here.

Abstract

Since the 80's, extracorporeal techniques have been used in pediatrics for the most severe acute respiratory distress syndromes. In 2012, data from the International Register of the Extracorporeal Life Support Organization revealed that more than 5,000 children had undergone extracorporeal membrane oxygenation (ECMO) with an increase in the number of annual cases since the epidemics of 2009. The survival rate (56%) is stable while the number of children with comorbidities increases due to the improvements in the equipment. Although there are no randomized studies, results encourage considering ECMO in pediatric ARDS. If veno-venous ECMO should be preferred in respiratory diseases, veno-arterial ECMO may be necessary and is still used frequently in children (50% of cases). In pediatrics, the technical features are first related to the physiological characteristics of the child and secondly to the technical limitations of the available equipment in the different ages. ECMO is a technique requiring specific expertise and specialized pediatric teams due to children's particularities.

References

Flamant C, Hallalel F, Nolent P, Chevalier J, Renolleau S . Severe respiratory syncytial virus bronchiolitis in children: from short mechanical ventilation to extracorporeal membrane oxygenation. Eur J Pediatr. 2005; 164(2):93-8. DOI: 10.1007/s00431-004-1580-0. View

Maul T, Wolff E, Kuch B, Rosendorff A, Morell V, Wearden P . Activated partial thromboplastin time is a better trending tool in pediatric extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2012; 13(6):e363-71. DOI: 10.1097/PCC.0b013e31825b582e. View

Durandy Y . Characteristics of a nonocclusive pressure-regulated blood roller pump. Artif Organs. 2013; 37(1):97-100. DOI: 10.1111/j.1525-1594.2012.01566.x. View

Khoshbin E, Dux A, Killer H, Sosnowski A, Firmin R, Peek G . A comparison of radiographic signs of pulmonary inflammation during ECMO between silicon and poly-methyl pentene oxygenators. Perfusion. 2007; 22(1):15-21. DOI: 10.1177/0267659106075950. View

Lopez-Fernandez Y, Azagra A, de la Oliva P, Modesto V, Sanchez J, Parrilla J . Pediatric Acute Lung Injury Epidemiology and Natural History study: Incidence and outcome of the acute respiratory distress syndrome in children. Crit Care Med. 2012; 40(12):3238-45. DOI: 10.1097/CCM.0b013e318260caa3. View

Paden M, Warshaw B, Heard M, Fortenberry J . Recovery of renal function and survival after continuous renal replacement therapy during extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2010; 12(2):153-8. PMC: 4054600. DOI: 10.1097/PCC.0b013e3181e2a596. View

Downes J, Fulgencio T, Raphaely R . Acute respiratory failure in infants and children. Pediatr Clin North Am. 1972; 19(2):423-45. DOI: 10.1016/s0031-3955(16)32709-2. View

Bembea M, Annich G, Rycus P, Oldenburg G, Berkowitz I, Pronovost P . Variability in anticoagulation management of patients on extracorporeal membrane oxygenation: an international survey. Pediatr Crit Care Med. 2013; 14(2):e77-84. PMC: 3567253. DOI: 10.1097/PCC.0b013e31827127e4. View

Wong J, Smith T, Pitcher H, Hirose H, Cavarocchi N . Cerebral and lower limb near-infrared spectroscopy in adults on extracorporeal membrane oxygenation. Artif Organs. 2012; 36(8):659-67. DOI: 10.1111/j.1525-1594.2012.01496.x. View

10.

Piantino J, Wainwright M, Grimason M, Smith C, Hussain E, Byron D . Nonconvulsive seizures are common in children treated with extracorporeal cardiac life support. Pediatr Crit Care Med. 2013; 14(6):601-9. DOI: 10.1097/PCC.0b013e318291755a. View

11.

Minneci P, Kilbaugh T, Chandler H, Behar B, Russell Localio A, Deans K . Factors associated with mortality in pediatric patients requiring extracorporeal life support for severe pneumonia. Pediatr Crit Care Med. 2012; 14(1):e26-33. DOI: 10.1097/PCC.0b013e31826e7254. View

12.

Peek G, Firmin R . The inflammatory and coagulative response to prolonged extracorporeal membrane oxygenation. ASAIO J. 1999; 45(4):250-63. DOI: 10.1097/00002480-199907000-00003. View

13.

Jen H, Shew S . Hospital readmissions and survival after nonneonatal pediatric ECMO. Pediatrics. 2010; 125(6):1217-23. DOI: 10.1542/peds.2009-0696. View

14.

Khoshbin E, Westrope C, Pooboni S, Machin D, Killer H, Peek G . Performance of polymethyl pentene oxygenators for neonatal extracorporeal membrane oxygenation: a comparison with silicone membrane oxygenators. Perfusion. 2005; 20(3):129-34. DOI: 10.1191/0267659105pf797oa. View

15.

Brogan T, Zabrocki L, Thiagarajan R, Rycus P, Bratton S . Prolonged extracorporeal membrane oxygenation for children with respiratory failure. Pediatr Crit Care Med. 2012; 13(4):e249-54. DOI: 10.1097/PCC.0b013e31824176f4. View

16.

Haydin S, Onan B, Onan I, Ozturk E, Iyigun M, Yeniterzi M . Cerebral perfusion during cardiopulmonary bypass in children: correlations between near-infrared spectroscopy, temperature, lactate, pump flow, and blood pressure. Artif Organs. 2012; 37(1):87-91. DOI: 10.1111/j.1525-1594.2012.01554.x. View

17.

Kuo K, Cornell T, Shanley T, Odetola F, Annich G . The use of extracorporeal membrane oxygenation in pediatric patients with sickle cell disease. Perfusion. 2013; 28(5):424-32. PMC: 4414397. DOI: 10.1177/0267659113485873. View

18.

Hoover N, Heard M, Reid C, Wagoner S, Rogers K, Foland J . Enhanced fluid management with continuous venovenous hemofiltration in pediatric respiratory failure patients receiving extracorporeal membrane oxygenation support. Intensive Care Med. 2008; 34(12):2241-7. DOI: 10.1007/s00134-008-1200-y. View

19.

Khoshbin E, Roberts N, Harvey C, Machin D, Killer H, Peek G . Poly-methyl pentene oxygenators have improved gas exchange capability and reduced transfusion requirements in adult extracorporeal membrane oxygenation. ASAIO J. 2005; 51(3):281-7. DOI: 10.1097/01.mat.0000159741.33681.f1. View

20.

ASHBAUGH D, Bigelow D, Petty T, LeVine B . Acute respiratory distress in adults. Lancet. 1967; 2(7511):319-23. DOI: 10.1016/s0140-6736(67)90168-7. View