title: Pediatric Extracorporeal Life Support Using a Third Generation Diagonal Pump.
abstract: This study reports a single-centre experience of the Medos Deltastream diagonal-pump (DP3) for extracorporeal cardiac, pulmonary, or combined support in a single-center pediatric cohort. Twenty-seven consecutive patients with 28 runs of the DP3 between January 2013 and June 2014 were included for analysis. Median patient age, weight, and duration of support were 278 days (range: 0 days-14.2 years), 7.2 kg (range: 2.5-39 kg), and 8 days (range: 2-69 days). Midline sternotomy (n = 20, 71.4%) or cervical approaches (n = 8, 28.6%) were used for cannulation. The DP3 was employed for either veno-arterial extracorporeal life support (ECLS, n = 16), veno-venous extracorporeal membrane oxygenation (ECMO, n = 5), or ventricular assist devices (right ventricular assist device [RVAD], n = 1; left ventricular assist device [LVAD], n = 1; and univentricular assist device [UNIVAD], n = 5). Three patients initially supported with ECLS were switched to UNIVAD and one patient with UNIVAD was changed to ECLS. Required flow for neonates (n = 8) ranged between 0.2 and 0.75 L/min. Irreversible pump damage occurred in one patient during deairing after air block. Successful weaning, 30 day and hospital survival were 89.3% (n = 25), 85.7% (n = 24), and 71.4% (n = 20). All patients on UNIVAD, who did not require further extracorporeal respiratory assist, survived. In conclusion, the DP3 can be used for individual patient demands and adapted to their most suitable method of support. Meticulous flow adjustments render this pump highly effective for extracorporeal support particularly in pediatric patients.
authors.affiliation: From the *Department of Pediatric Cardiac Surgery, and †Department of Pediatric Cardiology, University-Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
authors.forename: Marlene
authors.initials: M
authors.lastname: Speth
authors.forename: Frank
authors.initials: F
authors.lastname: Münch
authors.forename: Ariawan
authors.initials: A
authors.lastname: Purbojo
authors.forename: Martin
authors.initials: M
authors.lastname: Glöckler
authors.forename: Okan
authors.initials: O
authors.lastname: Toka
authors.forename: Robert A
authors.initials: RA
authors.lastname: Cesnjevar
authors.forename: André
authors.initials: A
authors.lastname: Rüffer
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn