Single needle venovenous extracorporeal membrane oxygenation using a nonocclusive roller pump for rescue in infants and children.
In 1993, J.Y. Chevalier described a single needle venovenous extracorporeal membrane oxygenation (ECMO) system using a nonocclusive roller pump and alternating clamps for pulmonary support in neonates. We modified this system to use it in older children as well and for additional indications. Introducing a double raceway and 2 different sizes of tubing sets and performing percutaneous approach, we treated 21 children (age 1 day to 49 months) using this system. Indications for treatment were hypoxia and hypoxic induced myocardial dysfunction resulting from pulmonary failure, sepsis, and congenital defects. Of the children treated for neonatal indications, 7/9 survived. For 2 children ECMO was terminated because of intraventricular hemorrhage (IVH). In the pediatric group 5/7 of the children could be weaned from ECMO, and 2 children died after more than 30 days on ECMO. Two of the children who had been almost completely weaned died later because of therapy withdrawal following a brain death diagnosis. In the cardiac group, 3/5 of the children survived. We conclude that the described system is an effective venovenous ECMO system that reduces invasivity and expenditure.
Trittenwein
G
G
Department of Neonatology and Critical Care, University Hospital of Vienna, Austria.
Fürst
G
G
Golej
J
J
Frenzel
C
C
Burda
G
G
Hermon
M
M
Marx
M
M
Wollenek
G
G
Pollak
A
A
D000925:Anticoagulants / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000502:physiology; D016887:Cardiopulmonary Resuscitation; D002395:Catecholamines / Q000008:administration & dosage / Q000494:pharmacology; D002406:Catheterization, Peripheral; D002543:Cerebral Hemorrhage / Q000209:etiology; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000592:standards*; D006333:Heart Failure / Q000401:mortality / Q000628:therapy; D017583:Hemodiafiltration; D006801:Humans; D000860:Hypoxia / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality / Q000628:therapy; D009846:Oliguria / Q000188:drug therapy / Q000628:therapy; D011183:Postoperative Complications / Q000517:prevention & control; D012772:Shock, Septic / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome
D000925:Anticoagulants; D002395:Catecholamines