Pediatric

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Pediatric Intensive Care Preparedness and ECMO Availability in Children With…

Abstract Since the beginning of the pandemic Coronavirus Disease 2019 (COVID-19), calls were made for informed allocation of costly, limited health care resources such as extracorporeal membrane oxygenation (ECMO). At the time of writing, the number of children infected by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was relatively small,..

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Evaluation of Recirculation During Venovenous Extracorporeal Membrane Oxygenation Using Computational…

Abstract Recirculation in venovenous extracorporeal membrane oxygenation (VV ECMO) leads to reduction in gas transfer efficiency. Studies of the factors contributing have been performed using in vivo studies and computational models. The fixed geometry of previous computational models limits the accuracy of results. We have developed a finite element computational..

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American Society of ExtraCorporeal Technology: Development of Standards and Guidelines…

Abstract The development of standards and guidelines by professional societies offers clinicians guidance toward providing evidence-based care. The ultimate goals of standards and guidelines are to standardize care and improve patient safety and outcomes while also minimizing risk. The American Society of ExtraCorporeal Technology (AmSECT) currently offers perfusionists several clinical..

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Outcomes of Multiple Runs of Extracorporeal Membrane Oxygenation: An analysis…

Abstract Objective When patients deteriorate after decannulation from extracorporeal membrane oxygenation (ECMO), a second run of extracorporeal support may be considered. However, repeat cannulation can be difficult and poor outcomes associated with multiple ECMO runs are a concern. The aim of this study was to evaluate outcomes and identify factors..

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Investigation of Myocardial Protection During Pediatric CPB: Practical Experience in…

Abstract Many measures have been proposed for myocardial protection in pediatric congenital heart surgeries, but little data is available for China. This study investigates myocardial protection strategies in pediatric cardiopulmonary bypass (CPB) throughout China. Online questionnaires were delivered to 100 hospitals in 27 provinces. The number of yearly on-pump pediatric..

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Practical Management of ECPELLA

Abstract Veno-arterial extracorporeal membrane oxygenation (ECMO) is a strong mechanical circulatory device for patients with hemodynamic deterioration due to cardiogenic shock, but its drawback is an increase in left ventricular afterload. The Impella axial-flow transcatheter left ventricular assist device is a recently developed promising device to mechanically unload the left..

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Sustained Total All-Region (STAR) Perfusion: An Optimized Perfusion Strategy for…

Abstract Early iterations of the Norwood procedure used aortic cross-clamping, myocardial arrest, and, sometimes, deep hypothermic circulatory arrest. The resulting hypothermia and prolonged ischemia caused frequent cardiac, neurologic, renal, and other end-organ dysfunctions. Our group describes a novel technique, sustained total all-region (STAR) perfusion, which circumvents these issues by providing..

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Conventional Ultrafiltration During Elective Cardiac Surgery and Postoperative Acute Kidney…

Abstract Objective Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) serves to hemoconcentrate blood volume to avoid allogeneic blood transfusions. Previous studies have determined CUF volumes as a continuous variable are associated with postoperative acute kidney injury (AKI) after cardiac surgery, but optimal weight-indexed volumes that predict AKI have not been..

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Cardiopulmonary Bypass Duration and the Incidence of Pressure Injuries in…

A Retrospective Cohort Study Purpose The purpose of our study was to investigate the association between cardiopulmonary bypass (CPB) duration and the incidence of pressure injuries (PIs) in patients undergoing cardiovascular surgery. Design Retrospective chart review. Subjects and Setting Two hundred and eighty-eight patients who underwent cardiovascular surgery with CPB..

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Goal-Directed Perfusion to Reduce Acute Kidney Injury after Paediatric Cardiac…

Abstract Introduction Cardiac surgery-associated acute kidney injury (CS-AKI) occurs in up to 40%~60% of paediatric patients and increases postoperative morbidity and mortality. A goal-directed perfusion (GDP) strategy aimed at maintaining indexed oxygen delivery (DO2i) above the critical threshold (reported to be 260~300 mL/min/m2 in adults) during cardiopulmonary bypass (CPB), is effective..

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