Inflight use of extracorporeal membrane oxygenation for severe neonatal respiratory failure

Perfusion ◽  
1986 ◽  
Vol 1 (4) ◽  
pp. 281-287 ◽  
Author(s):  
J. Devn Cornish ◽  
Dale R Gerstmann ◽  
Martin J Begnaud ◽  
Donald M Null ◽  
Neil B Ackerman
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
The United States ◽  
Air Transport ◽  
Referral Centre ◽  
Therapeutic Measure ◽  
The Past ◽  
Membrane Oxygenation ◽  
Life Threatening ◽  
Ecmo Treatment

Extracorporeal membrane oxygenation (ECMO) is a heart-lung bypass technique which has been used over the past ten years to support some 300 neonates with life-threatening respiratory failure. It is estimated that, within the constraints of currently accepted treatment criteria, there are between 2,000 and 3,000 neonates born each year within the United States who require this extreme therapeutic measure. Unfortunately, since there are still relatively few medical centres in the country offering this type of support, it is frequently necessary to transport candidate neonates from the hospital of birth to a referral centre. This is generally a tenuous procedure since neonates who are sufficiently ill to require ECMO treatment are commonly poor transport risks. We report the first successful use of an ECMO system designed to be transported to the referring hospital, assembled, and used to support an infant on bypass for a controlled air transport back to the receiving medical centre. The potential for decreasing the morbidity and mortality of selected infants requiring ECMO support by the addition of this capability is discussed.

Pepper-Spray-induced Respiratory Failure Treated With Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1996 ◽  
Vol 98 (5) ◽  
pp. 961-963
Author(s):  
Deborah F. Billmire ◽  
Charles Vinocur ◽  
Maureen Ginda ◽  
Nancy B. Robinson ◽  
Howard Panitch ◽  
...  
Keyword(s):  
United States ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
The United States ◽  
Accidental Exposure ◽  
Membrane Oxygenation ◽  
Self Defense ◽  
Lack Of Information ◽  
Life Threatening ◽  
Serious Injury

Self-defense sprays have been available to the general public since the 1970s. They are easily obtained and over 6 million spray units were sold in the United States in 1993 alone. The intent of these sprays is to cause skin and mucosal irritation without producing serious injury. We describe the accidental exposure to pepper-gas spray of an infant who experienced immediate life-threatening respiratory distress followed by progressive deterioration. Ultimately, he required extracorporeal membrane oxygenation (ECMO) for survival. The decision to place the infant on ECMO was made more difficult by the lack of information about potential reversibility with this rare toxic cause of respiratory failure.

Trends in extracorporeal membrane oxygenation treatment from 2005 to 2018 in South Korea

Perfusion ◽  
2021 ◽  
pp. 026765912110181
Author(s):  
Hyoung-Won Cho ◽  
In-Ae Song ◽  
Tak Kyu Oh
Keyword(s):  
Respiratory Failure ◽  
South Korea ◽  
Extracorporeal Membrane Oxygenation ◽  
Hospital Mortality ◽  
Population Based ◽  
Case Volume ◽  
Health Records ◽  
Membrane Oxygenation ◽  
Treatment Indications ◽  
Ecmo Treatment

Introduction: This study aimed to investigate trends in extracorporeal membrane oxygenation (ECMO) treatment during 2005–2018 and examine factors associated with in-hospital mortality. Methods: We conducted a population-based cohort study based on health records obtained from the National Health Insurance Service database in South Korea. All adult patients (⩾18 years old) who received ECMO treatment in the intensive care unit after hospitalization from 2005 to 2018 were enrolled. Results: We analyzed data for 21,129 adult ECMO patients from 128 hospitals. The prevalence of ECMO treatment gradually and continuously increased from 4 per 100,000 individuals (95% confidence interval [CI]: 3–4) in 2005 to 67.4 per 100,000 individuals (95% CI: 65–68) in 2018. There was a significant increase in ECMO treatment for acute respiratory distress syndrome (ARDS) or respiratory failure (from 2.5% during 2005–2008 to 14.5% during 2016–2018). The overall in-hospital and 30-day mortality rates of the patients were 48.4% and 53.5%, respectively. The in-hospital mortality rate was highest among patients with shock (62.1%) and lowest among ECMO patients with liver failure (21.6%). On multivariable logistic regression, a higher hospital case volume was associated with improvement in in-hospital mortality (p < 0.001). Conclusions: In South Korea, the prevalence of ECMO treatment has increased gradually and continuously between 2005 and 2018. There was a significant increase in the prevalence of ECMO treatment for ARDS or respiratory failure. Our results support that ECMO treatment indications have been expanding, and ECMO will become vital for treating critically ill patients in the future.

scholarly journals Recovery from respiratory failure after 49-day extracorporeal membrane oxygenation support in a critically ill patient with COVID-19: case report

2020 ◽  
Author(s):  
Fengwei Guo ◽  
Chao Deng ◽  
Tao Shi ◽  
Yang Yan
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Critically Ill ◽  
Life Support ◽  
Critically Ill Patient ◽  
Hypoxemic Respiratory Failure ◽  
Plasma Therapy ◽  
Form Of Life ◽  
Membrane Oxygenation ◽  
Life Threatening

Abstract Background Respiratory failure is a life-threatening complication of coronavirus disease 2019 (COVID-19)-related acute respiratory distress syndrome. Extracorporeal membrane oxygenation (ECMO) in COVID-19 might offer promise based on our clinical experience. However, few critically ill cases with COVID-19 have been weaned off ECMO. Case summary A 66-year-old Chinese woman presented with fever (38.9°C), cough, dyspnoea, and headache. She had lymphopenia (0.72 × 109/L) and computed tomography findings of ground-glass opacities. Subsequently, she was confirmed to have respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. She was intubated after transfer to the intensive care unit due to respiratory failure and heart failure. However, her condition continued to deteriorate rapidly. Veno-veno ECMO was undertaken for respiratory and cardiac support due to refractory hypoxemic respiratory failure and bradyarrhythmia (45 b.p.m.). During hospitalization, she was also administered anti-viral treatment, convalescent plasma therapy, and continuous renal replacement therapy. She was maintained on ECMO before she had fully recovered from the condition that necessitated ECMO use and had a negative test for the nucleic acids of SARS-CoV-2 twice. Forty-nine days later, this patient was weaned from ECMO. At the most recent follow-up visit (3 months after weaning from ECMO), she received respiratory and cardiac rehabilitation and did not complain of any discomfort. Discussion As far as we know, the longest duration of ECMO treatment in this critical case with COVID-19 is supportive of ECMO as the most aggressive form of life support and the last line of defence during the COVID-19 epidemic.

scholarly journals EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO) – IN THE TREATMENT OF SEVERE, LIFE-THREATENING RESPIRATORY FAILURE

2019 ◽  
Vol 72 (9) ◽  
pp. 1822-1828
Author(s):  
Krystian Ślusarz ◽  
Paulina Kurdyś ◽  
Paul Armatowicz ◽  
Piotr Knapik ◽  
Ewa Trejnowska
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Invasive Mechanical Ventilation ◽  
Lung Damage ◽  
Respiratory Support ◽  
Membrane Oxygenation ◽  
Clinical Complications ◽  
Life Threatening

Extracorporeal membrane oxygenation (ECMO) is a technique involving oxygenation of blood and elimination of carbon dioxide in patients with life-threatening, but potentially reversible conditions. Thanks to the modification of extracorporeal circulation used during cardiac surgeries, this technique can be used in intensive care units. Venovenous ECMO is used as a respiratory support, while venoarterial ECMO as a cardiac and/or respiratory support. ECMO does not cure the heart and/or lungs, but it gives the patient a chance to survive a period when these organs are inefficient. In addition, extracorporeal membrane oxygenation reduces or eliminates the risk of lung damage associated with invasive mechanical ventilation in patients with severe ARDS (acute respiratory distress syndrome). ECMO is a very invasive therapy, therefore it should only be used in patients with extremely severe respiratory failure, who failed to respond to conventional therapies. According to the Extracorporeal Life Support Organization (ELSO) Guidelines, inclusion criteria are: PaO2 / FiO2 < 80 for at least 3 hours or pH < 7.25 for at least 3 hours. Proper ECMO management requires advanced medical care. This article discusses the history of ECMO development, clinical indications, contraindications, clinical complications and treatment outcomes.

Neonatal Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1988 ◽  
Vol 82 (2) ◽  
pp. 276-277
Author(s):  
STEVEN M. DONN
Keyword(s):  
United States ◽  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
The United States ◽  
Membrane Oxygenation ◽  
Widespread Acceptance ◽  
Long Term Follow Up ◽  
Ecmo Therapy

The number of centers providing extracorporeal membrane oxygenation (ECMO) therapy to newborns with intractable respiratory failure has grown dramatically. The ECMO registry now includes 37 institutions in the United States,1 and there may be additional centers offering ECMO but not participating in the registry. To date, more than 1,400 patients have been treated with ECMO with a survival rate exceeding 80%. Widespread acceptance of ECMO therapy has been accomplished despite a paucity of controlled clinical trials2 and without the benefit of long-term follow-up of survivors. Initial fervor about neonatal ECMO has stemmed from the excellent survival statistics cited by most of the earlier investigators.2-4

One- to Three-Year Outcome for 14 Neonatal Survivors of Extracorporeal Membrane Oxygenation

PEDIATRICS ◽  
1986 ◽  
Vol 78 (4) ◽  
pp. 692-698
Author(s):  
Alice French Andrews ◽  
Cynthia A. Nixon ◽  
Robert E. Cilley ◽  
Dietrich W. Roloff ◽  
Robert H. Bartlett
Keyword(s):  
Respiratory Failure ◽  
Extracorporeal Membrane Oxygenation ◽  
Growth And Development ◽  
Normal Growth ◽  
Term Infant ◽  
Control Group ◽  
Mental Ability ◽  
Membrane Oxygenation ◽  
Life Threatening ◽  
Near Term

Extracorporeal membrane oxygenation, using venoarterial or venovenous perfusion, is a safe and effective procedure in the term or near-term infant with life-threatening respiratory failure. Without extracorporeal membrane oxygenation, due to the severity of their disease, these children are at high risk for neurologic damage, chronic lung disease, and death. Because survival is not expected without extracorporeal membrane oxygenation therapy, there is no corresponding control group to which these survivors may be compared. In this report, we reviewed the outcome at 1 to 3 years in the first 14 survivors of extracorporeal membrane oxygenation treated at our institution. Seven of 14 neonatal extracorporeal membrane oxygenation survivors (50%) were normal or near normal at between 1 and 3 years of age. Ten (71%) had normal mental ability. We conclude that in neonates with high mortality risk from respiratory failure, near-normal growth and development can be expected in the majority who survive with extracorporeal membrane oxygenation treatment.

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