scholarly journals ECMO A Terapia Que Salva Vidas: Revisão Sistemática / ECMO Life-Saving Therapy: Systematic Review

2021 ◽  
Vol 15 (54) ◽  
pp. 341-356
Author(s):  
Ágatha Patricia Rodrigues Ribeiro
Keyword(s):  
Systematic Review ◽  
Systematic Reviews ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Extracorporeal Life Support Organization ◽  
Support Organization ◽  
Life Saving ◽  
Evidence Database ◽  
Meta Analyses

Resumo: A circulação extracorpórea prolongada promovida a partir de um dispositivo mecânico de uso temporário podendo durar dias ou meses. Com o intuito de fornecer suporte ao coração e o pulmão até promoção de sua recuperação ou substituição. O objetivo deste estudo é explorar os aspectos mais relevantes da circulação extracorpórea e contribuir cientificamente evidenciando os estudos realizados por meio de uma revisão sistemática da literatura. Realizada conforme as recomendações do Preferred Reporting Intens for Systematic Reviews and Meta-Analyses (PRISMA). A busca pelos artigos científicos ocorreu nas bases de dados eletrônicos Extracorporeal Life Support Organization (ELSO), PubMed, Literatura Latino Americana e do Caribe em ciências da Saúde (LILACS) e Scientific Eletronic Library Online (SciELO), PEDro (Physiotherapy  Evidence  Database) e buscas manuais nas referências dos artigos incluídos. Foi discutido o surgimento e expansão da utilização do ECMO pelo mundo, formas de utilização, qualidade de vida das crianças que utilizaram o ECMO a partir de avaliação neurológica, os riscos de infecções hospitalares associados a terapia, custo-beneficio, comparou-se o ECMO a outras terapias convencionais e os parâmetros ventilatórios, a mobilização precoce e seus benefícios e por fim o desmame. Conclui- se que a ECMO é uma terapia eficaz no tratamento da SDRA ou outras causas de insuficiência respiratória em adultos e crianças aumentando a sobrevida dos pacientes, sendo considerada uma terapia de resgate principalmente em transplantes de pulmão e coração por promover tempo de recuperação e substituição dos órgãos com eficiência e a relação custo-utilidade associada ao uso de oxigenação por membrana extracorpórea no Brasil é potencialmente aceitável.

scholarly journals ECMO em Recém-nascidos com Hérnia Diafragmática Congénita: A Experiência de um Centro de Referência de ECMO em Portugal

2020 ◽  
Vol 33 (12) ◽  
pp. 819
Author(s):  
Mariana Miranda ◽  
Francisco Abecasis ◽  
Sofia Almeida ◽  
Erica Torres ◽  
Leonor Boto ◽  
...  
Keyword(s):  
Congenital Diaphragmatic Hernia ◽  
Diaphragmatic Hernia ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Ventilatory Support ◽  
Pediatric Intensive Care ◽  
Cycle Duration ◽  
Extracorporeal Life Support Organization ◽  
Support Organization ◽  
Technological Advances

Introduction: The use of extracorporeal membrane oxygenation (ECMO) is considered by many authors as one of the most important technological advances in the care of newborns with congenital diaphragmatic hernia. The main objective of this study was to report the experience of a Portuguese ECMO center in the treatment of congenital diaphragmatic hernia.Material and Methods: Descriptive retrospective study of newborns with congenital diaphragmatic hernia requiring ECMO support in a Pediatric Intensive Care Unit from January 2012 to December 2019. Data collection using the Extracorporeal Life Support Organization registration and unit data base.Results: Fourteen newborns were included, all with left congenital diaphragmatic hernia, in a total of 15 venoarterial ECMO cycles. The median gestational age was 38 weeks and the median birth weight was 2.950 kg. Surgical repair was performed before entry into ECMO in six, during in seven and after in one newborn. The average age at placement was 3.3 days and the median cycle duration was 16 days. Prior to ECMO, all newborns had severe hypoxemia and acidosis despite optimized ventilatory support, with nitric oxide and inotropic therapy. After 24 hours on ECMO, there was correction of acidosis, improvement of oxygenation and hemodynamic stability. All cycles presented mechanical complications, the most frequent being the presence of clots in the circuit. The most frequent physiological complications were hemorrhagic and embolic (three newborns suffered an ischemic stroke during the cycle). Five newborns (35.7%) died, all associated with complications (two strokes, two massive bleedings and one accidental decannulation). Chronic lung disease, poor weight gain and psychomotor developmental delay were the most frequent long-term morbidities.Discussion: Despite technological advances in respiratory care and improved safety of the ECMO technique, the management of these newborns is complex and there are still several open questions, including the appropriate selection of patients, the best approach and time for surgical correction, and the treatment of pulmonary hypertension in the presence of persistent fetal shunts.Conclusion: Survival rate was higher than reported in 2017 Extracorporeal Life Support Organization report (64% versus 50%). Mechanical and hemorrhagic complications were very frequent.

Extracorporeal Life Support Organization Registry International Report 2016

ASAIO Journal ◽  
2017 ◽  
Vol 63 (1) ◽  
pp. 60-67 ◽  
Author(s):  
Ravi R. Thiagarajan ◽  
Ryan P. Barbaro ◽  
Peter T. Rycus ◽  
D. Michael Mcmullan ◽  
Steven A. Conrad ◽  
...  
Keyword(s):  
Life Support ◽  
Extracorporeal Life Support ◽  
Extracorporeal Life Support Organization ◽  
Support Organization ◽  
International Report

scholarly journals Outcomes of Pediatric Patients with Abdominal Sepsis Requiring Surgery and Extracorporeal Membrane Oxygenation Using the Extracorporeal Life Support Organization Database

2015 ◽  
Vol 81 (3) ◽  
pp. 245-251 ◽  
Author(s):  
Michael R. Phillips ◽  
Amal L. Khoury ◽  
Briana J. K. Stephenson ◽  
Lloyd J. Edwards ◽  
Anthony G. Charles ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Pediatric Patients ◽  
Clinical Decision Making ◽  
Life Support ◽  
Extracorporeal Life Support ◽  
Abdominal Sepsis ◽  
Bleeding Complications ◽  
Extracorporeal Life Support Organization ◽  
Membrane Oxygenation ◽  
Support Organization

No study describes the use of extracorporeal membrane oxygenation (ECMO) in pediatric patients with abdominal sepsis (AS) requiring surgery. A description of outcomes in this patient population would assist clinical decision-making and provide a context for discussions with patients and families. The Extracorporeal Life Support Organization database was queried for pediatric patients (30 days to 18 years) with AS requiring surgery. Forty-five of 61 patients survived (73.8%). Reported bleeding complications (57.1 vs 48.8%), the number of pre-ECMO ventilator hours (208.1 vs 178.9), and the timing of surgery before (50 vs 66.7%) and on-ECMO (50 vs 26.7%) were similar in survivors and nonsurvivors. Decreased pre-ECMO mean pH (7.1 vs 7.3) was associated with increased mortality (odds ratio, 1.49; 95% confidence interval, 1.04 to 2.14). ECMO use for pediatric patients with AS requiring surgery is associated with increased mortality and an increased rate of bleeding complications compared with all pediatric patients receiving ECMO support. Acidemia predicts mortality and provides a potential target of examination for future studies.

Extracorporeal Life Support Organization 1993

ASAIO Journal ◽  
1993 ◽  
Vol 39 (4) ◽  
pp. 976-979
Author(s):  
Charles J. H. Stolar ◽  
Thomas Delosh ◽  
Robert H. Bartlett
Keyword(s):  
Life Support ◽  
Extracorporeal Life Support ◽  
Extracorporeal Life Support Organization ◽  
Support Organization
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