Absence of Rapid Deployment Extracorporeal Membrane Oxygenation (ECMO) Team Does Not Preclude Resuscitation ECMO in Pediatric Cardiac Patients With Good Results

Department of Thoracic and Cardiovascular Surgery, Children's Hospital La Timone, Marseille, France.
ASAIO journal (American Society for Artificial Internal Organs: 1992) (Impact Factor: 1.52). 11/2007; 53(6):692-5. DOI: 10.1097/MAT.0b013e318151412f
Source: PubMed


We evaluated the results of using extracorporeal membrane oxygenation (ECMO) as resuscitation for cardiac patients undergoing cardiopulmonary resuscitation (CPR) in our setting where neither perfusionists nor surgeons are always on site, and no circuit may be ready. Between 2003 and 2006, we used ECMO for all cardiac patients who underwent cardiac arrest in the pediatric intensive care unit (PICU) or Cath Laboratory. We reviewed retrospectively 14 consecutive files (15 episodes). Mean CPR time before ECMO institution was 44 minutes (10-110 minutes). The surgeons, perfusionist, and scrub nurse, not on site for three of these patients, had to be called in simultaneously with institution of CPR. Two died on ECMO, the third one was successfully transplanted after 5 days. Globally, 10 patients could be weaned (66%). Eight patients (57%) survived to hospital discharge, seven without obvious neurological damage. One patient was bridged to a left ventricular assist device (LVAD) and was eventually successfully transplanted. He had an ischemic brain lesion with good recuperation and no sequel. We obtained good results with resuscitation ECMO in our setting where a permanently on-site rapid deployment ECMO team is not present at all times.

Download full-text


Available from: Bernard Kreitmann
  • [Show abstract] [Hide abstract]
    ABSTRACT: Extracorporeal membrane oxygenation (ECMO) is prolonged cardiopulmonary bypass used to treat critically ill patients with severe but reversible cardiac and/or respiratory failure. The severity of their symptoms, the rapid deterioration in their conditions, the difficulty in mechanical transportation, and the risks of traveling with an ECMO circuit often prohibit cannulation in an operating room. Cannulation for and decannulation after ECMO therapy can be safely accomplished in the intensive care unit by utilizing experienced perioperative nurses.
    No preview · Article · Apr 1997 · Nursing Clinics of North America
  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective: To investigate the effects and values of extracorporeal membrane oxygenation (ECMO) used in patients after cardiac arrest. Method: During five years period from June 2002 to June 2007, fifteen cases taken for cardiopulmonary resuscitation were treated by using ECMO in the emergency department and ICU. All the measures for disgnosis and treatment were observed to the guidelines for cardiopulmonary resuscitation and emergency cardiovasculat care set by the American Heart Association in 2005, and ECMO was applied in addition. The study was a self-comparison trial. The biomarkers including heart rate (HR), mean arterial pressure(MAP), central venous pressure(CVP), arterial partial oxygen pressure (PaO2), arterial partial pressure of carbon dioxide (PCO2), oxygen saturation (SaO2), hydrogen power (PH), and concentration of lactic acid were taken and assayed before and 10 min, 1 h, 6 h, 12 h, and 24 h after treatment. Differences between the results of measurements were analysed by t-test for matched pairs using SPSS version 10.0 software package. Neurological sequelae was also observed and described. Results: Ten minutes after ECMO treatment, MAP rose dramatically (P < 0.01) and got to further higher level one hour later (P < 0.05). On the other hand, CVP dropped off 10 minutes after ECMO treatment and further lowered one hour later, and PaO2 and SaO2 were improved apparently (P < 0.01), and pH was increased significantly (P < 0.01), while a derease in concentration of arterial LA of significantly (P < 0.01 ). Of the 15 cases, 11 patients got well, including completely recovered without sequelae in 5, memory disorders in 2 and hemipleggia in 2 patients. Conclusions: ECMO provides effective blood flow to hearts, and therefore, improves oxygenation and oxygen consumption greatly. Moreover, it provides stable oxygenated blood to brain and therefore, it is a good approach to cardiopulmonary cerebral resuscitation.
    No preview · Article · Dec 2007 · Zhongguo wei zhong bing ji jiu yi xue = Chinese critical care medicine = Zhongguo weizhongbing jijiuyixue
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: The overall objective of this unique meeting is to bring together internationally known clinicians, bioengineers, and basic scientists involved in the research of pediatric mechanical cardiac support systems and pediatric cardiopulmonary bypass procedures. The primary focus is to explicitly describe the problems with current pediatric mechanical circulatory support systems, methods, and techniques during acute and chronic support. The organizers of these continuing events believe that, in bringing together respected international scholars from 27 different countries, there has been a significant global impact made on the treatment of pediatric cardiac patients during the past three years alone. Over 800 participants from many countries, including Argentina, Australia, Austria, Belgium, Brazil, Canada, China, Finland, France, Germany, Greece, Ireland, Italy, Japan, Kuwait, Netherlands, New Zealand, Poland, South Korea, Saudi Arabia, Scotland, Spain, Switzerland, Taiwan, Turkey, the United Kingdom, and the United States, have participated in the 2005, 2006, and 2007 events.To date, this International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion is the only conference solely dedicated to pediatric cardiac devices during acute and chronic mechanical circulatory support. There is no other national or international conference to precisely define the problems with pediatric cardiac patients, and to suggest solutions with new methodologies and devices for pediatric patients, specifically neonates and infants. The objectives of this editorial are to review the outcomes of these three events and share future directions.
    Full-text · Article · Mar 2008 · ASAIO journal (American Society for Artificial Internal Organs: 1992)
Show more