Extracorporeal Membrane Oxygenation in Critically Ill Children - 04/06/22

Doi : 10.1016/j.pcl.2022.01.008

Katherine Cashen, DO ^a,^b,^⁎ , Katherine Regling, DO ^c,^d, Arun Saini, MD, MS ^e,^f
^a Division of Pediatric Critical Care Medicine, Department of Pediatrics, Duke Children’s Hospital, Durham, NC, USA
^b Duke University Medical Center, 2301 Erwin Road, Suite 5260Y, DUMC 3046, Durham, NC 27710, USA
^c Division of Pediatric Hematology Oncology, Children’s Hospital of Michigan, 3901 Beaubien Boulevard, Detroit, MI 48201, USA
^d Central Michigan University, Mt. Pleasant, MI, USA
^e Division of Pediatric Critical Care Medicine, Texas Children’s Hospital, 6651 Main Street, Suite 1411, Houston, TX 77030, USA
^f Baylor University School of Medicine, Houston, TX, USA

^∗Corresponding author. Duke University Medical Center, 2301 Erwin Road, Suite 5260Y, DUMC 3046, Durham, NC 27710.Duke University Medical Center2301 Erwin Road, Suite 5260Y, DUMC 3046DurhamNC27710

Résumé

Neonatal and pediatric extracorporeal membrane oxygenation (ECMO) has evolved over the past 50 years. Advances in technology, expertise, and application have increased the number of centers providing ECMO with expanded indications for use. However, increasing the use of ECMO in recent years to more medically complex critically ill children has not changed overall survival despite increased experience and improvements in technology. This review focuses on ECMO history, circuits, indications and contraindications, management, complications, and outcome data. The authors highlight important areas of progress, including unintubated and awake patients on ECMO, application during the COVID-19 pandemic, and future directions.

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Keywords : Pediatric intensive care unit, Infants, Children, Extracorporeal membrane oxygenation