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Anticoagulation Changes and Biochemical Signals Preceding Hospital-Acquired Infections in Pediatric Extracorporeal Support

Abstract Hospital-acquired infection (HAI) is a major complication in pediatric patients on extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Infection detection is challenging, as traditional inflammatory markers..

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Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Cardiac Catheterization Laboratory: Incidence, Risk Scoring, and Outcomes

Abstract Pediatric patients undergoing cardiac catheterization are at risk of major adverse events, including cardiac arrest and the need for extracorporeal membrane oxygenation support. The primary aim of this study..

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Efficacy of universal genome sequencing in infant extracorporeal membrane oxygenation

Abstract Objective To evaluate the feasibility and diagnostic yield of universal genome sequencing (GS) in infants receiving extracorporeal membrane oxygenation (ECMO). Study design Prospective multicenter study across eight Children’s Hospital..

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Transfusion of blood products to neonatal and pediatric extracorporeal membrane oxygenation patients: A prospective, observational study

Abstract Study Question To describe the blood product utilization during neonatal and pediatric extracorporeal membrane oxygenation (ECMO) and to determine whether its usage correlates with clinical outcomes of bleeding, thrombosis..

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Plasma Biomarkers of Brain Injury in Critically Ill Children Receiving Extracorporeal Membrane Oxygenation

Abstract Importance  Timely identification of acute brain injury (ABI) in children receiving extracorporeal membrane oxygenation (ECMO) support is critical for early neuroprotective interventions. Objectives  To determine if elevations in plasma glial fibrillary..

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Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis

Abstract Background Survival following the Norwood procedure has improved substantially, but outcomes for the high-risk subgroup requiring postoperative extracorporeal membrane oxygenation (ECMO) remain unclear. We explored short- and intermediate-term outcomes..

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Impaired Cerebral Autoregulation in Pediatric Patients with ECMO: A Retrospective Analysis of ECMO Time Periods and Association with Neurologic Injury

Abstract Objective Neurologic injury is common in pediatric patients with extracorporeal membrane oxygenation (ECMO). Impaired cerebral autoregulation (CAR) may increase the risk of neurologic injury. We aimed to measure CAR..

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Feasibility of “Awake” Extracorporeal Membrane Oxygenation Cannulation Before Intubation in Children

Abstract When the risk of cardiopulmonary arrest during intubation is high, “awake” extracorporeal membrane oxygenation (ECMO) cannulation with sedation and a natural airway may provide hemodynamic stability and gas exchange..

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Neonatal extracorporeal membrane oxygenation outcomes according to social determinants of health

Abstract Objective To characterize relationships between social determinants of health (SDoH) and mortality among infants receiving extracorporeal membrane oxygenation (ECMO). Study design Retrospectively, we identified infants born >34weeks gestation and..

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Patterns of Multiple Organ Dysfunction in Children on Extracorporeal Membrane Oxygenation Support

Abstract We present the first characterization of multiple organ dysfunction (OD) patterns and their associations with in-hospital mortality for children on extracorporeal membrane oxygenation (ECMO). We retrospectively assessed OD for..

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Time to extracorporeal cardiopulmonary resuscitation flow and outcomes in paediatric in-hospital cardiac arrest: a 12-year single-centre study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory paediatric in-hospital cardiac arrest (IHCA). Although rapid initiation of extracorporeal life support (ECLS) is widely considered critical, the relative..

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Association between platelet indices and next-day bleeding and clotting in children and adults on extracorporeal membrane oxygenation: A retrospective study

Abstract Introduction Bleeding and clotting phenotypes are common in patients supported with Extracorporeal Membrane Oxygenation (ECMO) and are associated with increased mortality. However, tools to distinguish bleeding from clotting phenotypes..

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Pediatric Extracorporeal Cardiopulmonary Resuscitation (ECPR): Understanding Variations in Systems and Clinical Practice

Abstract Extracorporeal cardiopulmonary resuscitation (ECPR) for pediatric cardiac arrest relies on enhanced resources and time-critical decision-making. We aimed to evaluate variations in systems and clinical practice among extracorporeal membrane oxygenation..

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Neighborhood Opportunity and Long-Term Outcomes Following Pediatric Extracorporeal Membrane Oxygenation

Abstract Objective To evaluate whether neighborhood-level opportunity, measured by the Child Opportunity Index (COI), is associated with short- and long-term outcomes following pediatric extracorporeal membrane oxygenation (ECMO). Design Retrospective observational..

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Rethinking paracorporeal lung assist device support in the modern era: Why so different than ECMO?

Abstract Background Pediatric patients with combined irreversible pulmonary disease and right ventricular (RV) failure on conventional ECMO face significant challenges with rehabilitation and transplant candidacy. We describe our institutional experience..

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NAVA use in infants with established bronchopulmonary dysplasia, congenital diaphragmatic hernia, and those on ECMO: a narrative literature review

Abstract Neurally Adjusted Ventilatory Assist (NAVA) is an innovative mode of ventilation that delivers support in synchrony with the infant’s diaphragmatic electrical activity. This technology aims to improve patient–ventilator interaction,..

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Trends in Neonatal Extracorporeal Membrane Oxygenation (ECMO) in New York State: 2018-2024

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) has been used in the care of critically ill neonates since the 1970s. Some neonatal ECMO indications include inadequate tissue oxygen delivery, severe hypoxic..

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Left Ventricular Venting Using a Transaortic Pigtail Catheter in Pediatric Myocarditis Requiring Extracorporeal Membrane Oxygenation

Abstract Patients with fulminant myocarditis accompanied by severe hemodynamic deterioration, cardiogenic shock, or refractory arrhythmias often require venoarterial extracorporeal membrane oxygenation (VA-ECMO) treatment. When left ventricular (LV) dilation, elevated LV..

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Ischemic and hemorrhagic stroke in pediatric patients after extracorporeal membrane oxygenation decannulation: a systematic review

Abstract OBJECTIVE Extracorporeal membrane oxygenation (ECMO) is a vital support for pediatric patients with severe cardiac or pulmonary failure. However, post-decannulation complications, particularly involving carotid artery ligation (CAL) or carotid..

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Body Mass Index and Survival in Children Receiving Extracorporeal Membrane Oxygenation

Abstract Importance  Underweight and obesity represent opposite ends of the nutritional risk spectrum that negatively affect children’s health worldwide. Both conditions have been associated with increased mortality in pediatric patients receiving..

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Predictors of Brain Infarction in Pediatric Patients During Extracorporeal Membrane Oxygenation

Abstract Introduction Brain infarction (BI) is a severe complication of extracorporeal membrane oxygenation (ECMO) with high morbidity and mortality. We aimed to determine the incidence of BI and identify predictors..

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Anticoagulation management and monitoring in ECMO: an international survey: communication from the ISTH SSC Subcommittee on Pediatric and Neonatal Thrombosis…

Abstract Objectives The objective of this survey is to assess current practices in anticoagulation management, laboratory monitoring, and hematology involvement in extracorporeal membrane oxygenation (ECMO) patients. Methods A cross-sectional international..

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Impact of early hyperoxia on outcomes during neonatal and pediatric veno-arterial extracorporeal life support

Abstract Background: Hyperoxia induces oxidative stress and can exacerbate inflammatory response to Veno-Arterial Extracorporeal Life Support (VA–ECLS). This study aimed to evaluate the association between hyperoxia during VA–ECLS and morbidity, complications,..

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A bedside staffing model with perfusionists for pediatric extracorporeal membrane oxygenation (ECMO) at a high-volume center

Abstract Background: Extracorporeal membrane oxygenation (ECMO) in pediatric patients requires monitoring by specialists to optimize outcomes. Practice variability exists among pediatric ECMO centers across the country. We present a bedside..

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Bivalirudin Monitoring Using Dilute Thrombin Time in Pediatric Extracorporeal Membrane Oxygenation: Single-Center, Retrospective Cost Analysis, 2018–2023

Abstract Objectives:  The parenteral anticoagulant bivalirudin has favorable safety and efficacy outcomes compared with unfractionated heparin (UFH) in pediatric patients requiring extracorporeal membrane oxygenation (ECMO), and is frequently monitored using..

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Every second counts: Association between activated clotting time and neurologic injury in neonatal ECMO

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a critical support modality for patients with reversible cardiopulmonary failure. Despite its benefits, ECMO is associated with neurologic adverse events (NAE), including seizures..

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Difficult cannulations in neonatal and pediatric ECMO: Illuminating obstructions to timely therapy

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) provides life-saving support for patients with advanced cardiorespiratory failure, yet unanticipated difficulties with peripheral cannulation can delay therapy. This study describes challenging neonatal and..

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Sweep Gas Nitric Oxide During Extracorporeal Membrane Oxygenation in Neonates and Children (NECTAR Trial): A Single-Center, Pilot Randomized Controlled Trial

Abstract Objectives:  To test the feasibility and safety of a randomized controlled trial (RCT) delivering nitric oxide into the sweep gas of extracorporeal membrane oxygenation (ECMO) circuits (sNO) in critically..

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Pediatric ECPR as Bridge to Surgery: Successful Management of Refractory Cardiac Arrest in High-Risk ICD Lead Extraction

Abstract Background Refractory cardiac arrest remains a major challenge in children, with poor survival despite advances in cardiopulmonary resuscitation (CPR). Extracorporeal cardiopulmonary resuscitation (ECPR), defined as rapid deployment of extracorporeal..

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Pediatric Extracorporeal Membrane Oxygenation (ECMO) Transport Safety—Regional and National Experiences and Literature Review

Abstract Background/Objectives: Venovenous extracorporeal membrane oxygenation (VV ECMO) supports reversible respiratory failure when mechanical ventilation fails. Technological advances and specialized teams now enable ECMO initiation at referring centers, even for high-risk..

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