Evolution of Technology, Establishment of Program, and Clinical Outcomes in Pediatric Extracorporeal Membrane Oxygenation

The "SickKids" Experience

Yasuhiro Kotani, Osami Honjo, Lisa Davey, Devin Chetan, Anne Marie Guerguerian, Colleen Gruenwald

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Technological development has had a tremendous impact on the management of patients who require extracorporeal membrane oxygenation (ECMO). Team development and education are a vital component of a successful extracorporeal life support (ECLS) Program to reduce complications and subsequently improve clinical outcomes. We sought to review the evolution in technology, importance of team development and training, and report our experience at The Hospital for Sick Children, Toronto. There were a total of 576 ECMO runs in 534 patients (42 repeat ECMO runs) between January 1988 and June 2012. The use of ECMO for cardiac disease has increased in the last decade due to an expanded indication for ECMO in patients with single-ventricle physiology. Cardiac ECMO still remains a challenge in terms of survival (177/392, 45%). Although development of an ECLS program and team education facilitated extracorporeal cardiopulmonary resuscitation, clinical outcomes were not satisfactory (survival, 33%). The most common complications were hemorrhagic (13.8%), followed by renal (10.6%) and pulmonary dysfunction (6.9%). Advances in technology made management during ECMO safer, and the mechanical complications related to the ECMO system were 6.1%, including circuit changes due to thrombus formation, cannula repositioning, or optimization of size.

Original languageEnglish
Pages (from-to)21-28
Number of pages8
JournalArtificial Organs
Volume37
Issue number1
DOIs
Publication statusPublished - Jan 2013
Externally publishedYes

Fingerprint

Extracorporeal Membrane Oxygenation
Pediatrics
Oxygenation
Technology
Membranes
Education
Resuscitation
Physiology
Survival
Cardiopulmonary Resuscitation
Heart Diseases
Thrombosis
Networks (circuits)
Kidney
Lung

Keywords

  • Extracorporeal membrane oxygenation
  • Pediatric
  • Team development
  • Technology

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

Cite this

Evolution of Technology, Establishment of Program, and Clinical Outcomes in Pediatric Extracorporeal Membrane Oxygenation : The "SickKids" Experience. / Kotani, Yasuhiro; Honjo, Osami; Davey, Lisa; Chetan, Devin; Guerguerian, Anne Marie; Gruenwald, Colleen.

In: Artificial Organs, Vol. 37, No. 1, 01.2013, p. 21-28.

Research output: Contribution to journalArticle

Kotani, Yasuhiro ; Honjo, Osami ; Davey, Lisa ; Chetan, Devin ; Guerguerian, Anne Marie ; Gruenwald, Colleen. / Evolution of Technology, Establishment of Program, and Clinical Outcomes in Pediatric Extracorporeal Membrane Oxygenation : The "SickKids" Experience. In: Artificial Organs. 2013 ; Vol. 37, No. 1. pp. 21-28.
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