Pediyatrik EKMO

ecmo-kapak

Op. Dr. Murat UĞURLUCAN,
Özel Anadolu Sağlık Merkezi Hastanesi, Kalp ve Damar Cerrahisi Kliniği
Prof. Dr. Sertaç ÇİÇEK
Özel Anadolu Sağlık Merkezi Hastanesi, Kalp ve Damar Cerrahisi Kliniği

Özet

Erişkin hastalarda EKMO ile uygulanan tedaviler ilk başlarda yüz güldürücü olama-masına rağmen aynı dönemde solunum yetmezliği nedeniyle pediyatrik vakalardaki uygulamalar son derece başarılı olmuştur. Sağlık ve teknoloji alanındaki gelişmelerle beraber günümüzde EKMO, hayat kurtarıcı rolünün yanı sıra, tedavi edici ve önleyici görevlerde de sıklıkla kullanılabilmektedir. Yenidoğan ve pediyatrik yaş grubu, erişkin-den farklı olarak kendine özgü anatomik, fizyolojik, metabolik, immunolojik, inflamat-uar mekanizmalara sahiptir. Bu nedenle erişkin ve pediyatrik hastalar arasındaki fizyopatolojik mekanizmalar iyi bilinmeli, EKMO uygulanmak istendiğinde parame-treler pediyatrik grubun özelliklerine göre ayarlanmalıdır. Tüm bunların ötesinde EKMO’nun hasta için faydası ve beklentiler göz önünde bulundurulmalıdır. İlerleyen teknoloji, anestezi ve cerrahi tekniklere rağmen EKMO halen mortalitesi yüksek olabilmektedir. Hastane maliyetlerini de önemli ölçüde arttırmaktadır. EKMO her ne kadar uygun vakalarda kullanıldığında hayat kurtarıcı olsa da kardiyopulmoner yetmezliği olan her hasta için endikasyon tartışmalıdır ve birçok komplikasyonu beraberinde getirebilir. Hastadaki patoloji iyi değerlendirilmeli, alternatif tedavi yöntemleri gözden geçirilmeli, gerekiyorsa uygulanmalı ve son çare olarak kardiyopul-moner fonksiyonları yeniden geri dönebilecek en uygun hastalara uygulanmalıdır.

Referanslar

  1. McMullan M, Elliot MJ, Cohen GA. ECMO for Infants and Children. In: Gravlee GP, Davis RF, Stammers AH, Un-gerleider RM, eds. Cardiopulmonary Bypass Principles and Practice. Philadelphia: Wolters Kluwer/Lippincott Willi-ams&Wilkins: 2008. p.735-56.
  2. Cicek MS, Arslan AH. Konjenital Kalp Hastalıkları ve Pediatrik Perfüzyon. In: Demirkılıç U, eds. Ekstrakorporal Do-laşım. Ankara: Eflatun Yayınevi; 2008. p.326-40.
  3. Frenckner B, Radell P. Respiratory failure and extracorporeal membrane oxygenation. Semin Pediatr Surg 2008;17(1):34-41.
  4. Dalton HJ, Butt WW. Extracorporeal life support: an update of Rogers' Textbook of Pediatric Intensive Care. Pediatr Crit Care Med 2012;13(4):461-71.
  5. Thiagarajan RR, Laussen PC, Rycus PT, Bartlett RH, Bratton SL. Extracorporeal membrane oxygenation to aid car-diopulmonary resuscitation in infants and children. Circulation 2007;116(15):1693-700.
  6. Fiser RT, Morris MC. Extracorporeal cardiopulmonary resuscitation in refractory pediatric cardiac arrest. Pediatr Clin North Am 2008;55(4):929-41.
  7. Flick RP, Sprung J, Gleich SJ, Barnes RD, Warner DO, Dearani JA, et al. Intraoperative extracorporeal membrane oxygenation and survival of pediatric patients undergoing repair of congenital heart disease. Paediatr Anaesth 2008;18(8):757-66.
  8. Sachweh JS, Tiete AR, Fuchs A, Römer U, Kozlik-Feldmann R, Reichart B, et al. Efficacy of extracorporeal membrane oxygenation in a congenital heart surgery program. Clin Res Cardiol 2007;96(4):204-10.
  9. Ayad O, Dietrich A, Mihalov L. Extracorporeal membrane oxygenation. Emerg Med Clin North Am 2008;26(4):953-9.
  10. Ugurlucan M, Basaran M, Alpagut U, Tireli E. Bidirectional inferior vena cava-pulmonary artery shunt: can it be an al-ternative for older patients presenting single ventricle heart disease in the third world countries? Arch Med Sci 2008;4, 1: 1–6.
  11. Singh AR. Neonatal and pediatric extracorporeal membrane oxygenation. Heart Dis 2002;4(1):40-6.
  12. Skinner SC, Hirschl RB, Bartlett RH. Extracorporeal life support. Semin Pediatr Surg 2006;15(4):242-50.
  13. Raymond TT, Cunnyngham CB, Thompson MT, Thomas JA, Dalton HJ, Nadkarni VM; American Heart Association National Registry of CPR Investigators. Outcomes among neonates, infants, and children after extracorporeal car-diopulmonary resuscitation for refractory inhospital pediatric cardiac arrest: a report from the National Registry of Car-diopulmonary Resuscitation. Pediatr Crit Care Med 2010;11(3):362-71.
  14. Imamura M, Dossey AM, Prodhan P, Schmitz M, Frazier E, Dyamenahalli U, et al. Bridge to cardiac transplant in children: Berlin Heart versus extracorporeal membrane oxygenation. Ann Thorac Surg 2009;87(6):1894-901.
  15. http://emedicine.medscape.com/article/1818617-overview
  16. http://en.wikipedia.org/wiki/Extracorporeal_membrane_oxygenation
  17. Beiras-Fernandez A, Deutsch MA, Kainzinger S, Kaczmarek I, Sodian R, Ueberfuhr P, et al. Extracorporeal membrane oxygenation in 108 patients with low cardiac output – a single-center experience. Int J Artif Organs 2011;34(4):365-73.
  18. Schaible T, Hermle D, Loersch F, Demirakca S, Reinshagen K, Varnholt V. A 20-year experience on neonatal extra-corporeal membrane oxygenation in a referral center. Intensive Care Med 2010;36(7):1229-34.
  19. Schlapbach LJ, Grips M, Justo R, Karl T. Extracorporeal membrane oxygenation as a bridge to diagnosis in a 20-month old girl with pulmonary hypertension and right ventricular failure. Interact Cardiovasc Thorac Surg 2012;15(6):1088-9.
  20. Matsumiya G, Saitoh S, Sawa Y. Extracorporeal assist circulation for heart failure. Circ J. 2009 Jun;73 Suppl A:A42-7.
  21. Arrington CB, Kouretas PC, Mart CR. Extracorporeal membrane oxygenation as a bridge to surgical treatment of flail tricuspid valve in a neonate. Cardiol Young 2005;15(6):660-2.
  22. Delmo Walter EM, Alexi-Meskishvili V, Huebler M, Loforte A, Stiller B, Weng Y, et al. Extracorporeal membrane oxy-genation for intraoperative cardiac support in children with congenital heart disease. Interact Cardiovasc Thorac Surg 2010;10(5):753-8.
  23. Hsu KH, Chi NH, Yu HY, Wang CH, Huang SC, Wang SS, et al. Extracorporeal membranous oxygenation support for acute fulminant myocarditis: analysis of a single center's experience. Eur J Cardiothorac Surg 2011;40(3):682-8.
  24. Teele SA, Allan CK, Laussen PC, Newburger JW, Gauvreau K, Thiagarajan RR. Management and outcomes in pe-diatric patients presenting with acute fulminant myocarditis. J Pediatr 2011;158(4):638-43.
  25. Dyamenahalli U, Tuzcu V, Fontenot E, Papagiannis J, Jaquiss RD, Bhutta A, et al. Extracorporeal membrane oxy-genation support for intractable primary arrhythmias and complete congenital heart block in newborns and infants: short-term and medium-term outcomes. Pediatr Crit Care Med 2012;13(1):47-52.
  26. Scherrer V, Lasgi C, Hariri S, Dureuil B, Savouré A, Tamion F, et al. Radiofrequency ablation under extracorporeal membrane oxygenation for atrial tachycardia in postpartum. J Card Surg 2012;27(5):647-9.
  27. Thomas V, Lawrence D, Kogon B, Frias P. Epicardial ablation of ventricular tachycardia in a child on venoarterial ext-racorporeal membrane oxygenation. Pediatr Cardiol 2010;31(6):901-4.
  28. Bae JO, Frischer JS, Waich M, Addonizio LJ, Lazar EL, Stolar CJ. Extracorporeal membrane oxygenation in pediat-ric cardiac transplantation. J Pediatr Surg 2005;40(6):1051-6.
  29. Tissot C, Buckvold S, Phelps CM, Ivy DD, Campbell DN, Mitchell MB, et al. Outcome of extracorporeal membrane oxygenation for early primary graft failure after pediatric heart transplantation. J Am Coll Cardiol 2009;54(8):730-7.
  30. Puri V, Epstein D, Raithel SC, Gandhi SK, Sweet SC, Faro A, et al. Extracorporeal membrane oxygenation in pedi-atric lung transplantation. J Thorac Cardiovasc Surg 2010;140(2):427-32.
  31. Dyamenahalli U, Tuzcu V, Fontenot E, Papagiannis J, Jaquiss RD, Bhutta A, et al. Extracorporeal membrane oxy-genation support for intractable primary arrhythmias and complete congenital heart block in newborns and infants: short-term and medium-term outcomes. Pediatr Crit Care Med 2012;13(1):47-52.
  32. Skinner SC, Iocono JA, Ballard HO, Turner MD, Ward AN, Davenport DL, et al. Improved survival in venovenous vs venoarterial extracorporeal membrane oxygenation for pediatric noncardiac sepsis patients: a study of the Extracor-poreal Life Support Organization registry. J Pediatr Surg 2012;47(1):63-7.
  33. Maclaren G, Butt W, Best D, Donath S, Taylor A. Extracorporeal membrane oxygenation for refractory septic shock in children: one institution's experience. Pediatr Crit Care Med 2007;8(5):447-51.
  34. Trittenwein G, Pansi H, Graf B, Golej J, Burda G, Hermon M, et al. Proposed entry criteria for postoperative cardiac extracorporeal membrane oxygenation after pediatric open heart surgery. Artif Organs 1999;23(11):1010-4.
  35. Baslaim G, Bashore J, Al-Malki F, Jamjoom A. Can the outcome of pediatric extracorporeal membrane oxygenation after cardiac surgery be predicted? Ann Thorac Cardiovasc Surg 2006;12(1):21-7.
  36. http://www.childrensmn.org/web/nicu/138085.pdf
  37. http://www.childrensmn.org/web/nicu/138084.pdf
  38. Coskun KO, Coskun ST, Popov AF, Hinz J, El-Arousy M, Schmitto JD, et al. Extracorporeal life support in pediatric cardiac dysfunction. J Cardiothorac Surg 2010;5:112.
  39. Kumar J, Agarwal S, Hegde R, Rao S, John C, Reddy C, et al. Extracorporeal membrane oxygenation in postopera-tive pediatric cardiac surgical cases. Indian Heart J 2009;61(1):55-7.
  40. Itoh H, Ichiba S, Ujike Y, Kasahara S, Arai S, Sano S. Extracorporeal membrane oxygenation following pediatric car-diac surgery: development and outcomes from a single-center experience. Perfusion 2012;27(3):225-9.
  41. Grist G, Whittaker C, Merrigan K, Fenton J, Pallotto E, Lofland G. Defining the late implementation of extracorporeal membrane oxygenation (ECMO) by identifying increased mortality risk using specific physiologic cut-points in neo-natal and pediatric respiratory patients. J Extra Corpor Technol 2009;41(4):213-9.
  42. Chai PJ, Jacobs JP, Dalton HJ, Costello JM, Cooper DS, Kirsch R, et al. Extracorporeal cardiopulmonary resuscita-tion for post-operative cardiac arrest: indications, techniques, controversies, and early results--what is known (and unk-nown). Cardiol Young 2011;21 Suppl 2:109-17.
  43. Wolf MJ, Kanter KR, Kirshbom PM, Kogon BE, Wagoner SF. Extracorporeal cardiopulmonary resuscitation for pedi-atric cardiac patients. Ann Thorac Surg 2012;94(3):874-80.
  44. Nance ML, Nadkarni VM, Hedrick HL, Cullen JA, Wiebe DJ. Effect of preextracorporeal membrane oxygenation ven-tilation days and age on extracorporeal membrane oxygenation survival in critically ill children. J Pediatr Surg 2009;44(8):1606-10.
  45. Domico MB, Ridout DA, Bronicki R, Anas NG, Cleary JP, Cappon J, et al. The impact of mechanical ventilation time before initiation of extracorporeal life support on survival in pediatric respiratory failure: a review of the Extracorpo-real Life Support Registry. Pediatr Crit Care Med 2012;13(1):16-21.
  46. Gray BW, Shaffer AW, Mychaliska GB. Advances in neonatal extracorporeal support: the role of extracorporeal mem-brane oxygenation and the artificial placenta. Clin Perinatol 2012;39(2):311-29.
  47. Kattan J, Godoy L, Zavala A, Faunes M, Becker P, Estay A, et al. Improvement of survival in infants with congenital diaphragmatic hernia in recent years: effect of ECMO availability and associated factors. Pediatr Surg Int 2010;26(7):671-6.
  48. Guner YS, Khemani RG, Qureshi FG, Wee CP, Austin MT, Dorey F, et al. Outcome analysis of neonates with con-genital diaphragmatic hernia treated with venovenous vs venoarterial extracorporeal membrane oxygenation. J Pe-diatr Surg 2009;44(9):1691-701.
  49. Janssen DJ, Zimmermann LJ, Cogo P, Hamvas A, Bohlin K, Luijendijk IH, et al. Decreased surfactant phospha-tidylcholine synthesis in neonates with congenital diaphragmatic hernia during extracorporeal membrane oxygena-tion. Intensive Care Med 2009;35(10):1754-60.
  50. Ramachandrappa A, Rosenberg ES, Wagoner S, Jain L. Morbidity and mortality in late preterm infants with severe hypoxic respiratory failure on extra-corporeal membrane oxygenation. J Pediatr 2011;159(2):192-8.
  51. Zabrocki LA, Brogan TV, Statler KD, Poss WB, Rollins MD, Bratton SL. Extracorporeal membrane oxygenation for pe-diatric respiratory failure: Survival and predictors of mortality. Crit Care Med 2011;39(2):364-70.
  52. Turner DA, Rehder KJ, Peterson-Carmichael SL, Ozment CP, Al-Hegelan MS, Williford WL, et al. Extracorporeal membrane oxygenation for severe refractory respiratory failure secondary to 2009 H1N1 influenza. A Respir Care 2011;56(7):941-6.
  53. Chan T, Thiagarajan RR, Frank D, Bratton SL. Survival after extracorporeal cardiopulmonary resuscitation in infants and children with heart disease. J Thorac Cardiovasc Surg 2008;136(4):984-92.
  54. Gow KW, Heiss KF, Wulkan ML, Katzenstein HM, Rosenberg ES, Heard ML, et al. Extracorporeal life support for sup-port of children with malignancy and respiratory or cardiac failure: The extracorporeal life support experience. Crit Care Med 2009;37(4):1308-16.
  55. Polimenakos AC, Wojtyla P, Smith PJ, Rizzo V, Nater M, El Zein CF, et al. Post-cardiotomy extracorporeal cardio-pulmonary resuscitation in neonates with complex single ventricle: analysis of outcomes. Eur J Cardiothorac Surg 2011;40(6):1396-405.
  56. Thourani VH, Kirshbom PM, Kanter KR, Simsic J, Kogon BE, Wagoner S, et al. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) in pediatric cardiac support. Ann Thorac Surg 2006;82(1):138-44.
  57. Debrunner MG, Porayette P, Breinholt JP 3rd, Turrentine MW, Cordes TM. Midterm Survival of Infants Requiring Po-stoperative Extracorporeal Membrane Oxygenation After Norwood Palliation. Pediatr Cardiol 2012;34(3):570-5.
  58. Pluim T, Halasa N, Phillips SE, Fleming G. The morbidity and mortality of patients with fungal infections before and during extracorporeal membrane oxygenation support*. Pediatr Crit Care Med 2012;13(5):e288-93.
  59. Mehta NM, Turner D, Walsh B, Zurakowski D, Betit P, Wilson J, Arnold JH. Factors associated with survival in pedi-atric extracorporeal membrane oxygenation--a single-center experience. J Pediatr Surg 2010;45(10):1995-2003.
  60. Ruangnapa K, Samransamruajkit R, Namchaisiri J, Pongsanont K, Boonthim K, Deelodejanawong J, et al. The long duration of extracorporeal membrane oxygenation in a child with acute severe hypoxic respiratory failure treated in a resource-limited center. Perfusion 2012;27(6):547-9.
  61. Wang S, Haines N, Undar A. Quantification of pressure-flow waveforms and selection of components for the pulsa-tile extracorporeal circuit. J Extra Corpor Technol 2009;41(1):P20-5.
  62. Wang S, Haines N, Undar A. Hemodynamic energy delivery of the pulsatile flow in a simulated pediatric extracorpo-real circuit. ASAIO J 2009;55(1):96-9.
  63. Wang S, Haines N, Richardson JS, Dasse KA, Undar A. Impact of the postpump resistance on pressure-flow wave-form and hemodynamic energy level in a neonatal pulsatile centrifugal pump. ASAIO J. 2009;55(3):277-81.
  64. Barrett CS, Jaggers JJ, Cook EF, Graham DA, Rajagopal SK, Almond CS, et al. Outcomes of Neonates Undergoing Extracorporeal Membrane Oxygenation Support Using Centrifugal Versus Roller Blood Pumps. Ann Thorac Surg 2012;94(5):1635-41.
  65. Byrnes J, McKamie W, Swearingen C, Prodhan P, Bhutta A, Jaquiss R, et al. Hemolysis during cardiac extracorpo-real membrane oxygenation: a case-control comparison of roller pumps and centrifugal pumps in a pediatric popula-tion. ASAIO J 2011;57(5):456-61.
  66. De Somer F. Impact of oxygenator characteristics on its capability to remove gaseous microemboli. J Extra Corpor Technol 2007;39(4):271-3.
  67. Lynch JE, Hayes D Jr, Zwischenberger JB. Extracorporeal CO(2) removal in ARDS. Crit Care Clin 2011;27(3):609-25.
  68. Hogan MJ. Neonatal vascular catheters and their complications. Radiol Clin North Am 1999;37(6):1109-25.
  69. Miller A, Lu CK, Wang S, Umstead TM, Freeman WM, Vrana K, et al. Pediatric cardiopulmonary bypass circuits: a review of studies conducted at the Penn State Pediatric Cardiac Research Laboratories. J Extra Corpor Technol 2009;41(1):P50-8.
  70. Riley JB, Scott PD, Schears GJ. Update on safety equipment for extracorporeal life support (ECLS) circuits. Semin Cardiothorac Vasc Anesth 2009;13(3):138-45.
  71. Gander JW, Fisher JC, Reichstein AR, Gross ER, Aspelund G, Middlesworth W, et al. Limb ischemia after common femoral artery cannulation for venoarterial extracorporeal membrane oxygenation: an unresolved problem. J Pediatr Surg 2010;45(11):2136-40.
  72. Haley MJ, Fisher JC, Ruiz-Elizalde AR, Stolar CJ, Morrissey NJ, Middlesworth W. Percutaneous distal perfusion of the lower extremity after femoral cannulation for venoarterial extracorporeal membrane oxygenation in a small child. J Pediatr Surg 2009;44(2):437-40.
  73. Mathis CA, Powell AE, Holloway RD, Shah S, Goldberg SP, Boston US. Alternative cannulation strategy for pediat-ric ECMO. J Card Surg 2011;26(4):444-5.
  74. Byrnes J, Prodhan P, Imamura M, Frazier E. Accidental azygos vein extracorporeal membrane oxygenation cannu-lation in a neonate with premature closure of the ductus arteriosus. ASAIO J 2011;57(4):344-5.
  75. Haynes S, Kerber RE, Johnson FL, Lynch WR, Divekar A. Left heart decompression by atrial stenting during extra-corporeal membrane oxygenation. Int J Artif Organs 2009;32(4):240-2.
  76. Jaggers JJ, Forbess JM, Shah AS, Meliones JN, Kirshbom PM, Miller CE, et al. Extracorporeal membrane oxygena-tion for infant postcardiotomy support: significance of shunt management. Ann Thorac Surg 2000;69(5):1476-83.
  77. Platts DG, Sedgwick JF, Burstow DJ, Mullany DV, Fraser JF. The role of echocardiography in the management of pa-tients supported by extracorporeal membrane oxygenation. J Am Soc Echocardiogr 2012;25(2):131-41.
  78. Domico M, Chang A. ECHO for ECMO: not just for cardiac function. Pediatr Crit Care Med 2009;10(1):138.
  79. Thomas TH, Price R, Ramaciotti C, Thompson M, Megison S, Lemler MS. Echocardiography, not chest radiography, for evaluation of cannula placement during pediatric extracorporeal membrane oxygenation. Pediatr Crit Care Med 2009;10(1):56-9.
  80. Lidegran MK, Ringertz HG, Frenckner BP, Lindén VB. Chest and abdominal CT during extracorporeal membrane oxygenation: Clinical benefits in diagnosis and treatment. Acad Radiol 2005;12(3):276-85.
  81. Friedman BA, Schoepf UJ, Bastarrika GA, Hlavacek AM. Computed tomographic angiography of infants with conge-nital heart disease receiving extracorporeal membrane oxygenation. Pediatr Cardiol 2009;30(8):1154-6.
  82. Skinner SC, Iocono JA, Ballard HO, Turner MD, Ward AN, Davenport DL, Paden ML, Zwischenberger JB. Improved survival in venovenous vs venoarterial extracorporeal membrane oxygenation for pediatric noncardiac sepsis patients: a study of the Extracorporeal Life Support Organization registry. J Pediatr Surg 2012;47(1):63-7.
  83. Askegard-Giesmann JR, Besner GE, Fabia R, Caniano DA, Preston T, Kenney BD. Extracorporeal membrane oxy-genation as a lifesaving modality in the treatment of pediatric patients with burns and respiratory failure. J Pediatr Surg 2010;45(6):1330-5.
  84. Maul TM, Wolff EL, Kuch BA, Rosendorff A, Morell VO, Wearden PD. Activated partial thromboplastin time is a bet-ter trending tool in pediatric extracorporeal membrane oxygenation. Pediatr Crit Care Med 2012;13(6):e363-71.
  85. Davis MC, Andersen NE, Johansson P, Andersen LW. Use of thromboelastograph and factor VII for the treatment of postoperative bleeding in a pediatric patient on ECMO after cardiac surgery. J Extra Corpor Technol 2006;38(2):165-7.
  86. Wittenstein B, Ng C, Ravn H, Goldman A. Recombinant factor VII for severe bleeding during extracorporeal membrane oxygenation following open heart surgery. Pediatr Crit Care Med 2005;6(4):473-6.
  87. Dominguez TE, Mitchell M, Friess SH, Huh JW, Manno CS, Ravishankar C, et al. Use of recombinant factor VIIa for refractory hemorrhage during extracorporeal membrane oxygenation. Pediatr Crit Care Med 2005;6(3):348-51.
  88. Baird CW, Zurakowski D, Robinson B, Gandhi S, Burdis-Koch L, Tamblyn J, et al. Anticoagulation and pediatric ext-racorporeal membrane oxygenation: impact of activated clotting time and heparin dose on survival. Ann Thorac Surg 2007;83(3):912-9.
  89. Ranucci M, Ballotta A, Kandil H, Isgrò G, Carlucci C, Baryshnikova E, et al; Surgical and Clinical Outcome Research Group. Bivalirudin-based versus conventional heparin anticoagulation for postcardiotomy extracorporeal membrane oxygenation. Crit Care 2011;15(6):R275.
  90. Reed RC, Rutledge JC. Laboratory and clinical predictors of thrombosis and hemorrhage in 29 pediatric extracorpo-real membrane oxygenation nonsurvivors. Pediatr Dev Pathol 2010;13(5):385-92.
  91. Niebler RA, Christensen M, Berens R, Wellner H, Mikhailov T, Tweddell JS. Antithrombin replacement during extra-corporeal membrane oxygenation. Artif Organs 2011;35(11):1024-8.
  92. Hervey-Jumper SL, Annich GM, Yancon AR, Garton HJ, Muraszko KM, Maher CO. Neurological complications of extracorporeal membrane oxygenation in children. J Neurosurg Pediatr 2011;7(4):338-44.
  93. Niebler RA, Punzalan RC, Marchan M, Lankiewicz MW. Activated recombinant factor VII for refractory bleeding du-ring extracorporeal membrane oxygenation. Pediatr Crit Care Med 2010;11(1):98-102.
  94. Scott LK, Grier LR, Conrad SA. Heparin-induced thrombocytopenia in a pediatric patient receiving extracorporeal membrane oxygenation managed with argatroban. Pediatr Crit Care Med 2006;7(5):473-5.
  95. Hursting MJ, Dubb J, Verme-Gibboney CN. Argatroban anticoagulation in pediatric patients: a literature analysis. J Pediatr Hematol Oncol 2006;28(1):4-10.
  96. Garcia A, Gander JW, Gross ER, Reichstein A, Sheth SS, Stolar CJ, et al. The use of recombinant tissue-type plas-minogen activator in a newborn with an intracardiac thrombus developed during extracorporeal membrane oxygena-tion. J Pediatr Surg 2011;46(10):2021-4.
  97. Hanekamp MN, Spoel M, Sharman-Koendjbiharie I, Peters JW, Albers MJ, Tibboel D. Routine enteral nutrition in neonates on extracorporeal membrane oxygenation. Pediatr Crit Care Med 2005;6(3):275-9.
  98. Buck ML, Wooldridge P, Ksenich RA. Comparison of methods for intravenous infusion of fat emulsion during extra-corporeal membrane oxygenation. Pharmacotherapy 2005;25(11):1536-40.
  99. Jen HC, Shew SB. Hospital readmissions and survival after nonneonatal pediatric ECMO. Pediatrics 2010;125(6):1217-23.
  100. Blijdorp K, Cransberg K, Wildschut ED, Gischler SJ, Jan Houmes R, Wolff ED, et al. Haemofiltration in newborns treated with extracorporeal membrane oxygenation: a case-comparison study. Crit Care 2009;13(2):R48.
  101. Smith A, Hardison D, Bridges B, Pietsch J. Red blood cell transfusion volume and mortality among patients receiving extracorporeal membrane oxygenation. Perfusion 2013;28(1):54-60.
  102. Preston TJ, Olshove VF Jr, Chase M. Bloodless extracorporeal membrane oxygenation in the Jehovah's Witness pa-tient. J Extra Corpor Technol 2012;44(1):39-42.].
  103. Kurundkar AR, Killingsworth CR, McIlwain RB, Timpa JG, Hartman YE, He D, et al. Extracorporeal membrane oxy-genation causes loss of intestinal epithelial barrier in the newborn piglet. Pediatr Res. 2010;68(2):128-33.
  104. Vogel AM, Lew DF, Kao LS, Lally KP. Defining risk for infectious complications on extracorporeal life support. J Pe-diatr Surg 2011;46(12):2260-4.
  105. Garcia X, Mian A, Mendiratta P, Gupta P, Rycus P, Prodhan P. Aspergillus Infection and Extracorporeal Membrane Oxygenation Support. J Intensive Care Med 2013;28(3):178-84.
  106. Gardner AH, Prodhan P, Stovall SH, Gossett JM, Stern JE, Wilson CD, et al. Fungal infections and antifungal prophy-laxis in pediatric cardiac extracorporeal life support. J Thorac Cardiovasc Surg 2012;143(3):689-95.
  107. Bizzarro MJ, Conrad SA, Kaufman DA, Rycus P; Extracorporeal Life Support Organization Task Force on Infections, Extracorporeal Membrane Oxygenation. Infections acquired during extracorporeal membrane oxygenation in neona-tes, children, and adults. Pediatr Crit Care Med 2011;12(3):277-81.
  108. Wildschut ED, Hanekamp MN, Vet NJ, Houmes RJ, Ahsman MJ, Mathot RA, et al. Feasibility of sedation and anal-gesia interruption following cannulation in neonates on extracorporeal membrane oxygenation. Intensive Care Med 2010;36(9):1587-91.
  109. DeBerry BB, Lynch JE, Chernin JM, Zwischenberger JB, Chung DH. A survey for pain and sedation medications in pediatric patients during extracorporeal membrane oxygenation. Perfusion 2005;20(3):139-43.
  110. Haines NM, Rycus PT, Zwischenberger JB, Bartlett RH, Undar A. Extracorporeal Life Support Registry Report 2008: neonatal and pediatric cardiac cases. ASAIO J 2009;55(1):111-6.
  111. Fleming GM, Gurney JG, Donohue JE, Remenapp RT, Annich GM. Mechanical component failures in 28,171 neo-natal and pediatric extracorporeal membrane oxygenation courses from 1987 to 2006. Pediatr Crit Care Med 2009;10(4):439-44.
  112. Rollins MD, Hubbard A, Zabrocki L, Barnhart DC, Bratton SL. Extracorporeal membrane oxygenation cannulation trends for pediatric respiratory failure and central nervous system injury. J Pediatr Surg 2012;47(1):68-75.
  113. Amigoni A, Pettenazzo A, Biban P, Suppiej A, Freato F, Zaramella P, et al. Neurologic outcome in children after ext-racorporeal membrane oxygenation: prognostic value of diagnostic tests. Pediatr Neurol 2005;32(3):173-9.
  114. Lequier L, Joffe AR, Robertson CM, Dinu IA, Wongswadiwat Y, Anton NR, et al; Western Canadian Complex Pedi-atric Therapies Program Follow-up Group. Two-year survival, mental, and motor outcomes after cardiac extracorpo-real life support at less than five years of age. J Thorac Cardiovasc Surg 2008;136(4):976-83.
  115. Barrett CS, Bratton SL, Salvin JW, Laussen PC, Rycus PT, Thiagarajan RR. Neurological injury after extracorporeal membrane oxygenation use to aid pediatric cardiopulmonary resuscitation. Pediatr Crit Care Med 2009;10(4):445-51.
  116. Grosek S, Osredkar D, Derganc M, Neubauer D, Primozic J. Detection of seizures with amplitude-integrated elect-roencephalography in a neonate treated with extracorporeal membrane oxygenation. Zhongguo Dang Dai Er Ke Za Zhi 2008;10(4):547-51.
  117. Ejike JC, Schenkman KA, Seidel K, Ramamoorthy C, Roberts JS. Cerebral oxygenation in neonatal and pediatric pa-tients during veno-arterial extracorporeal life support. Pediatr Crit Care Med 2006;7(2):154-8.
  118. Rollins MD, Yoder BA, Moore KR, Barnhart DC, Jones C, Null DM, et al. Utility of neuroradiographic imaging in pre-dicting outcomes after neonatal extracorporeal membrane oxygenation. J Pediatr Surg 2012;47(1):76-80.
  119. Costello JM, O'Brien M, Wypij D, Shubert J, Salvin JW, Newburger JW, et al. Quality of life of pediatric cardiac pati-ents who previously required extracorporeal membrane oxygenation. Pediatr Crit Care Med 2012;13(4):428-34.
  120. Bembea MM, Savage W, Strouse JJ, Schwartz JM, Graham E, Thompson CB, et al. Glial fibrillary acidic protein as a brain injury biomarker in children undergoing extracorporeal membrane oxygenation. Pediatr Crit Care Med 2011;12(5):572-9.
  121. Friedlich P, Gonzalez J, Nield T, Keshava H, Stein J, Seri I, et al. Increased carotid artery intima-media thickness fol-lowing venoarterial extracorporeal membrane oxygenation in the neonatal period. J Perinatol 2008;28(12):811-4.
  122. Gbadegesin R, Zhao S, Charpie J, Brophy PD, Smoyer WE, Lin JJ. Significance of hemolysis on extracorporeal life support after cardiac surgery in children. Pediatr Nephrol 2009;24(3):589-95.
  123. Suzuki Y, Yamauchi S, Daitoku K, Fukui K, Fukuda I. Extracorporeal membrane oxygenation circulatory support after congenital cardiac surgery. ASAIO J 2009;55(1):53-7.
  124. Kamat PP, Popler J, Davis J, Leong T, Piland SC, Simon D, et al. Use of flexible bronchoscopy in pediatric patients receiving extracorporeal membrane oxygenation (ECMO) support. Pediatr Pulmonol 2011;46(11):1108-13.
  125. Prentice E, Mastropietro CW. Flexible bronchoscopy for children on extracorporeal membrane oxygenation for car-diac failure. Pediatr Crit Care Med 2011;12(4):422-5.
  126. Hofhuis W, Hanekamp MN, Ijsselstijn H, Nieuwhof EM, Hop WC, Tibboel D, et al. Prospective longitudinal evaluation of lung function during the first year of life after extracorporeal membrane oxygenation. Pediatr Crit Care Med 2011;12(2):159-64.
  127. Agar NJ, Berkowitz RG. Airway complications of pediatric extracorporeal membrane oxygenation. Ann Otol Rhinol Laryngol 2011;120(6):353-7.
  128. Smith AH, Hardison DC, Worden CR, Fleming GM, Taylor MB. Acute renal failure during extracorporeal support in the pediatric cardiac patient. ASAIO J 2009;55(4):412-6.
  129. Santiago MJ, Sánchez A, López-Herce J, Pérez R, del Castillo J, Urbano J, et al. The use of continuous renal repla-cement therapy in series with extracorporeal membrane oxygenation. Kidney Int 2009;76(12):1289-92.
  130. Betrus C, Remenapp R, Charpie J, Kudelka T, Brophy P, Smoyer WE, et al. Enhanced hemolysis in pediatric pati-ents requiring extracorporeal membrane oxygenation and continuous renal replacement therapy. Ann Thorac Car-diovasc Surg 2007;13(6):378-83.
  131. Askenazi DJ, Ambalavanan N, Hamilton K, Cutter G, Laney D, Kaslow R, et al. Acute kidney injury and renal repla-cement therapy independently predict mortality in neonatal and pediatric noncardiac patients on extracorporeal mem-brane oxygenation. Pediatr Crit Care Med 2011;12(1):e1-6.
  132. Paden ML, Warshaw BL, Heard ML, Fortenberry JD. Recovery of renal function and survival after continuous renal replacement therapy during extracorporeal membrane oxygenation. Pediatr Crit Care Med 2011;12(2):153-8.
  133. Abbasi S, Stewart DL, Radmacher P, Adamkin D. Natural course of cholestasis in neonates on extracorporeal mem-brane oxygenation (ECMO): 10-year experience at a single institution. ASAIO J 2008;54(4):436-8.
  134. Wildschut ED, Ahsman MJ, Houmes RJ, Pokorna P, de Wildt SN, Mathot RA, et al. Pharmacotherapy in neonatal and pediatric extracorporeal membrane oxygenation (ECMO). Curr Drug Metab 2012;13(6):767-77.
  135. Watt K, Li JS, Benjamin DK Jr, Cohen-Wolkowiez M. Pediatric cardiovascular drug dosing in critically ill children and extracorporeal membrane oxygenation. J Cardiovasc Pharmacol 2011;58(2):126-32.
  136. Bui KC, Senadheera D, Wang X, Hendrickson B, Friedlich P, Lutzko C. Recovery of multipotent progenitors from the peripheral blood of patients requiring extracorporeal membrane oxygenation support. Am J Respir Crit Care Med 2010;181(3):226-37.
  137. Prodhan P, Fiser RT, Dyamenahalli U, Gossett J, Imamura M, Jaquiss RD, et al. Outcomes after extracorporeal car-diopulmonary resuscitation (ECPR) following refractory pediatric cardiac arrest in the intensive care unit. Resuscita-tion 2009;80(10):1124-9.
  138. Bohuta L, d'Udekem Y, Best D, Alexander P, Barozzi L, Butt W. Outcomes of second-run extracorporeal life support in children: a single-institution experience. Ann Thorac Surg 2011;92(3):993-6.
  139. Kane DA, Thiagarajan RR, Wypij D, Scheurer MA, Fynn-Thompson F, Emani S, et al. Rapid-response extracorpo-real membrane oxygenation to support cardiopulmonary resuscitation in children with cardiac disease. Circulation 2010;122(11 Suppl):S241-8.
  140. Fisher JC, Stolar CJ, Cowles RA. Evaluating cannulation strategies used during second courses of extracorporeal membrane oxygenation in a large cohort of pediatric patients. J Pediatr Surg 2009;44(1):94-9.
  141. Yamasaki Y, Hayashi T, Nakatani T, Yotsuida H, Nishigaki T, Takahashi Y, et al. Early experience with low-prime (99 extracorporeal membrane oxygenation support in children. ASAIO J 2006;52(1):110-4.
  142. Reed RC, Rutledge JC. Laboratory and clinical predictors of thrombosis and hemorrhage in 29 pediatric extracorpo-real membrane oxygenation nonsurvivors. Pediatr Dev Pathol 2010;13(5):385-92.
  143. Alsoufi B, Al-Radi OO, Gruenwald C, Lean L, Williams WG, McCrindle BW, et al. Extra-corporeal life support follo-wing cardiac surgery in children: analysis of risk factors and survival in a single institution. Eur J Cardiothorac Surg 2009;35(6):1004-11.
  144. Alsoufi B, Al-Radi OO, Nazer RI, Gruenwald C, Foreman C, Williams WG, et al. Survival outcomes after rescue ext-racorporeal cardiopulmonary resuscitation in pediatric patients with refractory cardiac arrest. J Thorac Cardiovasc Surg 2007;134(4):952-9.
  145. Rajagopal SK, Almond CS, Laussen PC, Rycus PT, Wypij D, Thiagarajan RR. Extracorporeal membrane oxygena-tion for the support of infants, children, and young adults with acute myocarditis: a review of the Extracorporeal Life Support Organization registry. Crit Care Med 2010;38(2):382-7.
  146. Breckler FD, Molik KA, West KW. Influence of extracorporeal membrane oxygenation on subsequent surgeries after congenital diaphragmatic hernia repair. J Pediatr Surg 2009;44(6):1186-8.
  147. Chapman RL, Peterec SM, Bizzarro MJ, Mercurio MR. Patient selection for neonatal extracorporeal membrane oxy-genation: beyond severity of illness. J Perinatol 2009;29(9):606-11.