Open AccessExtracorporeal life support in pediatric patients
Author(s) -
Igor Kornilov
Publication year - 2018
Publication title -
patologiâ krovoobraŝeniâ i kardiohirurgiâ/patologiâ krovoobrašeniâ i kardiohirurgiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.136
H-Index - 3
eISSN - 2500-3119
pISSN - 1681-3472
DOI - 10.21688/1681-3472-2018-4-35-47
Subject(s) - medicine , extracorporeal membrane oxygenation , life support , extracorporeal , refractory (planetary science) , intensive care , life saving , intensive care medicine , respiratory distress , respiratory failure , acute respiratory distress , quality of life (healthcare) , surgery , medical emergency , lung , physics , astrobiology , nursing
Extracorporeal life support (ECLS) or extracorporeal membrane oxygenation (ECMO) is a life-saving therapy for critically ill children with high mortality, cardiac and/or respiratory failure refractory to conventional intensive treatment. In the last decade, the use of ECLS in pediatric intensive care has rapidly grown. The clinical indications and contraindications for ECLS have changed dramatically. The given review describes the fundamentals of ECMO technology, main clinical indications for ECLS and outcomes of ECMO in neonates and children. ECMO has become the standard for treatment of refractory acute heart failure, cardiac arrest, severe acute respiratory distress syndrome against the background of a decreasing number of contraindications. Although ECMO may be used nowadays to support even smaller babies and those with far more serious pathologies, careful consideration of the risk factors and probable outcomes is very important for decision to initiate and continue ECMO. The use and management of ECLS widely varies between clinics. Further multicenter studies are required to optimize patient selection criteria, cannulation and ECMO management, to reduce the number of complications and to analyze the quality of life of patients after ECMO and the cost effectiveness. Received 2 December 2018. Revised 14 December 2018. Accepted 14 December 2018. Funding: The study did not have sponsorship. Conflict of interest: Author declares no conflict of interest.