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Brain death: a clinical overview

Abstract Brain death, also commonly referred to as death by neurologic criteria, has been considered a legal definition of death for decades. Its determination involves many considerations and subtleties. In..

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Simultaneous electrical online estimation of changes in blood hematocrit and temperature in cardiopulmonary bypass

Abstract Two equations have been developed from multi-frequency measurements of blood impedance Zb for a simultaneous electrical online estimation of changes in blood hematocrit ΔH [%] and temperatures ΔT [K] in cardiopulmonary bypass (CPB). Zb of fixed blood..

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On-Hours Compared to Off-Hours Pediatric Extracorporeal Life Support Initiation in the United States Between 2009 and 2018—An Analysis of the…

Abstract OBJECTIVES:  We aimed to investigate whether there are differences in outcome for pediatric patients when extracorporeal life support (ECLS) is initiated on-hours compared with off-hours. DESIGN:  Retrospective cohort study...

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Preoperative Iron Supplementation in Pediatric Cardiac Surgical Patients: A Preliminary Single-Center Experience

Abstract Objective To assess preoperative hemoglobin and perioperative red blood cell transfusion in children undergoing cardiac surgery after the implementation of a preoperative patient blood management (PBM) clinic with oral..

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Impact of Heparin- or Nonheparin-Coated Circuits on Platelet Function in Pediatric Cardiac Surgery

Abstract Background: Extracorporeal circuit coating has been shown to improve coagulation derangements during pediatric cardiopulmonary bypass (CPB). This study compared platelet function and hemostasis activation in pediatric cardiac surgery conducted with..

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Patient blood management in critically ill children undergoing cardiac surgery: A cohort study

Abstract Objective The objective of this study was to audit current patient blood management practice in children throughout cardiac surgery and paediatric intensive care unit (PICU) admission. Design This was..

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Protective continuous ventilation strategy during cardiopulmonary bypass in children undergoing surgery for congenital heart disease: a prospective study

Abstract   OBJECTIVES The aim of this study was to evaluate if a ‘protective’ (low-tidal/low-frequency) ventilation strategy can shorten the postoperative ventilation time and minimize acute lung injury in children..

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Impact of a Multidisciplinary Research Team Approach to Prevent Avoidable Mistakes for Neonatal CPB Population

Abstract Significant progress has been made in neonatal cardiopulmonary bypass (CPB) over the years. At Penn State Health Children’s Hospital, we have established a multidisciplinary research team that brings clinicians,..

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Cerebral Infarction During Cervical Veno-Arterial Extracorporeal Membrane Oxygenation in Children: Can it be Predicted?

Abstract Veno-arterial extra-corporeal membrane oxygenation (VA ECMO) in children is often established by cannulation of the right carotid artery and the right internal jugular vein. Cerebral infarction which is sometimes..

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Oxidative Stress and Indicators of Brain Damage Following Pediatric Heart Surgery

Abstract Pediatric cardiac surgery induces an increased oxidative stress (OS) response. Increased OS is associated with poor neurologic outcomes in neonatal populations with similar patterns of brain injury. We investigated..

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Patterns and Determinants of Change in Cortisol Levels and Thyroid Function as a Function of Cardiac Risk in Children Undergoing…

Abstract Background. Children undergoing cardiac surgery with cardiopulmonary bypass (CPB) are exposed to the risk of hormonal imbalances resulting from acute stress, which may eventually result in high postoperative mortality..

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Comparison of the predictive ability of lactate and central venous blood gas in pediatric venoarterial mode extracorporeal membrane oxygenation outcome

Abstract Background This study aims to compare lactate and central venous blood gas in the prediction of outcome in pediatric venoarterial mode extracorporeal membrane oxygenation (V-A ECMO). Method This was..

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Veno-arterial extracorporeal membrane oxygenation for drug intoxications: A single center, 14-year experience

Abstract Background and Aim of the Study Acute cardiovascular failure remains a leading cause of death in severe poisonings. Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been increasingly used as a..

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Centrifugal Pump Generates Superior Hemodynamic Performance Compared to a new Diagonal Blood Pump in Neonatal and Pediatric ECMO Circuits

Abstract Purpose With newer generation diagonal and centrifugal blood pumps gaining popularity, the objective of this study was to compare the DP3-i-cor diagonal and RotaFlow centrifugal pumps in terms of..

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Feasibility of non-invasive neuro-monitoring during extracorporeal membrane oxygenation in children

Abstract Introduction Detection of neurological complications during extracorporeal membrane oxygenation (ECMO) may be enhanced with non-invasive neuro-monitoring. We investigated the feasibility of non-invasive neuro-monitoring in a paediatric intensive care (PIC)..

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Intracranial haemorrhage in adult patients on venoarterial extracorporeal membrane oxygenation Get access Arrow

Abstract Aims  Intracranial haemorrhage (ICH) is one of the most serious complications of adult patients treated with venoarterial extracorporeal membrane oxygenation (VA-ECMO) and is associated with increased morbidity and mortality...

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Development of a Model for the Pediatric Survival After Veno-Arterial Extracorporeal Membrane Oxygenation Score

Abstract Pediatric cardiac extracorporeal membrane oxygenation (ECMO) patients have high mortality rates. The purpose of our study was to develop and validate the Pediatric Survival After Veno-arterial ECMO (Pedi-SAVE) score for predicting..

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Rescue venovenous extracorporeal membrane oxygenation for the deterioration of acute respiratory distress syndrome in pediatric liver transplantation

Abstract Background Twenty percent of pediatric patients with BA develop ACLF with increased mortality while awaiting LT. Respiratory complications are common in pediatric ACLF and are associated with increased morbidity..

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Impaired Blood Flow? Tension Pneumothorax on Extracorporeal Support

Abstract A 55-year-old patient experiencing severe coronavirus disease 19 (COVID-19) related acute refractory respiratory failure requiring venovenous extracorporeal membrane oxygenation (VV-ECMO) support, with femoro-femoral approach, suddenly developed both signs of..

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Prothrombin Complex Concentrates to Treat Coagulation Disturbances: An Overview With a Focus on Use in Infants and Children

Abstract Various factors may lead to coagulation disturbances following cardiopulmonary bypass and surgery for congenital heart disease. In addition to the risks associated with the administration of allogeneic blood products,..

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Waitlist Outcomes for Children With Congenital Heart Disease: Lessons Learned From Over 5000 Heart Transplant Listings in the United States

Abstract Background We evaluated the impact of pediatric heart-allocation policy changes over time and the approval of the Berlin ventricular assist device (VAD) on waitlist (WL) outcomes for children with..

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Management of Circuit Air in Extracorporeal Membrane Oxygenation: A Single Center Experience

Abstract Air in circuit in patients receiving extracorporeal membrane oxygenation (ECMO) is an emergency. Different protocols have been suggested to deal with this rare but fatal complication, but their efficacies..

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Routine Neuroimaging: Understanding Brain Injury in Pediatric Extracorporeal Membrane Oxygenation*

Abstract OBJECTIVES:  This project aims to describe brain injuries on routine neuroimaging in a large single-center neonatal and pediatric cohort supported by extracorporeal membrane oxygenation. The study also aims to..

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Pediatric heart harvest

Surgical technique of pediatric heart harvest in patient with previous antrolateral thoracotomy and unfortunately brain death heart was used for transplantation because of absence of other associated anomalies and neither..

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Case Report of a Successful Pediatric Central Venovenous Extracorporeal life Support via Right Atrium-Pulmonary Artery Cannulation for Severe Chest Trauma…

Abstract Hypoxemic arrests due to severe traumatic pulmonary injury may not respond to usual medical support. Extracorporeal life support (ECLS) can be life-saving; adequate flows are needed in this setting..

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Measuring the Resting Energy Expenditure in Children on Extracorporeal Membrane Oxygenation: A Prospective Pilot Study

Abstract Both overfeeding and underfeeding critically ill children are problematic. This prospective pilot study evaluated the resting energy expenditure in infants and children requiring extracorporeal membrane oxygenation (ECMO) support. An..

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Pump-controlled retrograde trial off for weaning from adult veno-arterial extracorporeal membrane oxygenation – a retrospective observation cohort

Abstract Background The optimal strategy of weaning veno-arterial (V-A) extracorporeal membrane oxygenation (ECMO) remains poorly described. Pump-controlled retrograde trial off (PCRTO) involves serial decremental pump revolutions until a retrograde flow..

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How to avoid rapid carbon dioxide changes at the start of veno-venous extracorporeal membrane oxygenation: Role of end-tidal CO2 monitoring

Abstract Background: Venovenous ECMO is a lifesaving technique for patients with severe respiratory failure. Management of carbon dioxide (CO2) levels at ECMO start is crucial, as recent studies found an association..

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Initial results from an enhanced recovery program for pediatric cardiac surgical patients

Abstract Background Over recent years, a number of enhanced recovery programs have appeared in first, adult colorectal surgery, and subsequently many other adult surgical specialties. Increasing interest in this approach..

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