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 indirect calorimeter was used to measure oxygen consumption (VO2) and carbon dioxide production (VCO2) from the mechanical ventilator. Blood gases..
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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 from the arterial to venous ECMO cannula is achieved. It has been reported as a feasible weaning strategy in the..
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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 between rapid CO2 shifts and increased incidence of neurological complications. Purpose: To describe the role of end tidal CO2 (etCO2) monitoring at..
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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 to perioperative management in children culminated in the recent development of the first enhanced recovery pathway for pediatric intestinal surgery,..
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Abstract We assessed the accuracy of Masimo O3™ regional cerebral oxygen saturation (rSO2) readings by comparing them with reference values and evaluated the relationship between rSO2 and somatic tissue oxygen saturation (StO2) in children undergoing cardiac surgery. After anesthesia induction, pediatric sensors were applied to the forehead and foot sole, and..
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Abstract Pediatric patients, especially neonates and infants, undergoing cardiac surgery, are at particularly high risk for developing surgical bleeding. After separation from cardiopulmonary bypass (CPB), excessive bleeding in children frequently requires the administration of large volumes of blood products to achieve hemostasis. In the operating room (OR), this period of..
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Abstract Introduction: Pediatric extracorporeal membrane oxygenation (ECMO) is a high risk, low-volume technology. Infrequency of this technology and associated complications may translate to unfamiliarity of identification and management of potentially life-threatening events. Health care providers (HCP) involved in managing ECMO must be able to promptly identify and initiate management for..
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Abstract Extracorporeal life support (ECLS) is a treatment for acute respiratory failure that can provide extracorporeal gas exchange, allowing lung rest. However, while most patients remain mechanically ventilated during ECLS, there is a paucity of evidence to guide the choice of ventilator settings. We studied the associations between ventilator settings 24 hours after..
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Abstract Background We investigated the myocardial protective effect of a moderate-potassium cold blood cardioplegic solution (K+, 10 mmol/L) in pediatric cardiac surgery. Methods Sixty-eight pediatric patients with congenital heart disease and undergoing open heart surgery with cardiopulmonary bypass were randomly allocated to the high potassium (HP [K+, 20 mmol/L, n..
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Abstract Introduction This study aims to determine the oxygenator impact on alterations of peramivir (PRV) in a contemporary neonatal/pediatric (1/4-inch) and adolescent/adult (3/8-inch) extra-corporeal membrane oxygenation (ECMO) circuit including the Quadrox-i® oxygenator. Methods 1/4-inch and 3/8-inch, simulated closed-loop ECMO circuits were prepared with a Quadrox-i pediatric and Quadrox-i adult oxygenator and..
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