Improved Outcome of Cardiac Extracorporeal Membrane Oxygenation in Infants and Children Using Magnetic Levitation Centrifugal Pumps

2015 ◽  
Vol 40 (1) ◽  
pp. 27-33 ◽  
Author(s):  
Giovanni Battista Luciani ◽  
Stiljan Hoxha ◽  
Salvatore Torre ◽  
Alessio Rungatscher ◽  
Tiziano Menon ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Magnetic Levitation ◽  
Infants And Children ◽  
Centrifugal Pumps ◽  
Membrane Oxygenation ◽  
In Infants And Children ◽  
Improved Outcome

scholarly journals Extracorporeal Membrane Oxygenation to Aid Cardiopulmonary Resuscitation in Infants and Children

Circulation ◽  
2007 ◽  
Vol 116 (15) ◽  
pp. 1693-1700 ◽  
Author(s):  
Ravi R. Thiagarajan ◽  
Peter C. Laussen ◽  
Peter T. Rycus ◽  
Robert H. Bartlett ◽  
Susan L. Bratton
Keyword(s):  
Cardiopulmonary Resuscitation ◽  
Extracorporeal Membrane Oxygenation ◽  
Infants And Children ◽  
Membrane Oxygenation ◽  
In Infants And Children

scholarly journals Extracorporeal membrane oxygenation for respiratory and cardiac failure in infants and children

1987 ◽  
Vol 93 (2) ◽  
pp. 199-204 ◽  
Author(s):  
Clyde R. Redmond ◽  
Ernest D. Graves ◽  
Kenneth W. Falterman ◽  
John L. Ochsner ◽  
Robert M. Arensman
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Cardiac Failure ◽  
Infants And Children ◽  
Membrane Oxygenation ◽  
In Infants And Children

scholarly journals Effects of an Ex Vivo Pediatric Extracorporeal Membrane Oxygenation Circuit on the Sequestration of Mycophenolate Mofetil, Tacrolimus, Hydromorphone, and Fentanyl

2019 ◽  
Vol 24 (4) ◽  
pp. 290-295
Author(s):  
Catherine S. Heith ◽  
Lizbeth A. Hansen ◽  
Rhonda M. Bakken ◽  
Sharon L. Ritter ◽  
Breeanna R. Long ◽  
...  
Keyword(s):  
Mycophenolate Mofetil ◽  
Extracorporeal Membrane Oxygenation ◽  
Mycophenolic Acid ◽  
Pediatric Patients ◽  
Ex Vivo ◽  
Centrifugal Pumps ◽  
Ecmo Circuit ◽  
Binding Characteristics ◽  
Membrane Oxygenation ◽  
Set Up

OBJECTIVES With the expanding use of extracorporeal membrane oxygenation (ECMO), understanding drug pharmacokinetics has become increasingly important, particularly in pediatric patients. This ex vivo study examines the effect of a pediatric Quadrox-iD ECMO circuit on the sequestration and binding of mycophenolate mofetil (MMF), tacrolimus, and hydromorphone hydrochloride, which have not been extensively studied to date in pediatric ECMO circuits. Fentanyl, which has been well studied, was used as a comparator. METHODS ECMO circuits were set up using Quadrox-iD pediatric oxygenators and centrifugal pumps. The circuit was primed with whole blood and a reservoir was attached to represent a 5-kg patient. Fourteen French venous and 12 French arterial ECMO cannulas were inserted into the sealed reservoir. Temperature, pH, PO2, and PCO2 were monitored and corrected. MMF, tacrolimus, hydromorphone, and fentanyl were injected into the ECMO circuit. Serial blood samples were taken from a postoxygenator site at intervals over 12 hours, and levels were measured. RESULTS Hydromorphone hydrochloride was not as significantly sequestered by the ex vivo pediatric ECMO circuit when compared with fentanyl. Both mycophenolic acid and tacrolimus serum concentrations were stable in the circuit over 12 hours. CONCLUSIONS Hydromorphone may represent a useful medication for pain control for pediatric patients on ECMO due to its minimal sequestration. Mycophenolic acid and tacrolimus also did not show significant sequestration in the circuit, which was unexpected given their lipophilicity and protein-binding characteristics, but may provide insight into unexplored pharmacokinetics of particular medications in ECMO circuits.

scholarly journals A novel veno-arteriovenous extracorporeal membrane oxygenation with double pump for the treatment of Harlequin syndrome

Perfusion ◽  
2020 ◽  
Vol 35 (1_suppl) ◽  
pp. 65-72 ◽  
Author(s):  
Carlo Contento ◽  
Andrea Battisti ◽  
Bruno Agrò ◽  
Marina De Marco ◽  
Alessandra Iaiza ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Blood Clot ◽  
The Body ◽  
Clotting Factor ◽  
Centrifugal Pumps ◽  
Blood Flows ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation ◽  
Harlequin Syndrome ◽  
Venovenous Extracorporeal Membrane Oxygenation

Objectives: The Harlequin syndrome is a complication observed in patients receiving peripheral venoarterial extracorporeal membrane oxygenation. This condition is defined as a critical variation in the oxygen saturation between the upper and the lower part of the body deriving from a poor lung function. Methods: Between July 2018 and November 2019, a total of 60 patients (42 men and 18 women; mean age 57.4 ± 10.0 years; range = 28-71 years) underwent peripheral venoarterial extracorporeal membrane oxygenation in our center. Harlequin syndrome was identified in eight cases (six men and two women; 13.3%) of the 60 venoarterial extracorporeal membrane oxygenation–supported patients. As a result of the Harlequin syndrome, all these patients required conversion to veno-arteriovenous extracorporeal membrane oxygenation. Control and monitoring of the blood flows of the return cannulae were performed using two centrifugal pumps, one for each inlet line, according to the patient requirements to achieve optimum hemodynamic and oxygenation. Results: Mean duration of veno-arteriovenous extracorporeal membrane oxygenation support was 5.3 ± 1.4 days. Seven patients (87.5%) were switched to venovenous extracorporeal membrane oxygenation, and after 13.5 ± 2.7 days, those patients were totally weaned from extracorporeal membrane oxygenation support. One patient (12.5%) had an improvement in the pulmonary function, but the cardiac function was poor. This patient was switched to venoarterial extracorporeal membrane oxygenation, and after 10 days, the patient was completely weaned from extracorporeal membrane oxygenation support. Conclusion: The use of a secondary centrifugal pump to manage the blood flow directed to the internal jugular vein, in the veno-arteriovenous extracorporeal membrane oxygenation setup, allows the reduction in the risk of blood clot formation, clotting factor consumption, and pulmonary embolism when compared to the use of an external clamp.

Sign in / Sign up

Export Citation Format

Share Document