Pediatr Crit Care Me
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Pediatr Crit Care Me · Jun 2013
ReviewOutcomes following extracorporeal membrane oxygenation in children with cardiac disease.
Extracorporeal membrane oxygenation is a commonly used form of mechanical circulatory support in children with congenital or acquired heart disease and cardiac failure refractory to conventional medical therapies. In children with heart disease who suffer cardiac arrest, extracorporeal membrane oxygenation has been successfully used to provide cardiopulmonary support when conventional resuscitation has failed to establish return of spontaneous circulation. ⋯ Thus, a clear understanding of survival to discharge and long-term functional and neurologic outcomes are essential to guide the use of extracorporeal membrane oxygenation now and in the future. This review, part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support, summarizes current knowledge on short- and long-term outcomes for extracorporeal membrane oxygenation used to support children with cardiac disease.
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Pediatr Crit Care Me · Jun 2013
Multicenter Study Comparative StudyUsing administrative data for mortality risk adjustment in pediatric congenital cardiac surgery.
To evaluate the performance of risk-adjustment models from the University HealthSystem Consortium and the Agency for Healthcare Research Quality on an administrative dataset for children undergoing congenital cardiac surgery. ⋯ Administrative data can be used to create risk-adjustment models in the congenital cardiac surgery population. Risk-adjustment models generated from administrative data may represent an attractive addition to clinically derived models in pediatric congenital cardiac surgery patients and should be considered for use either alone or in combination with clinical data in future analyses where mortality is a measure of performance and quality.
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Pediatr Crit Care Me · Jun 2013
ReviewPediatric extracorporeal life support in specialized situations.
The purpose of this review was to provide a systematic review of the literature regarding the use of extracorporeal life support (ECLS) in various specialized conditions, as part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support. ⋯ The majority of specialized situations where extracorporeal life support is used fall into the category of class II-III evidence. Class I indications for extracorporeal life support in the pediatric population include myocarditis and in the context of acute interventions in the cardiac catheterization laboratory.
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Pediatr Crit Care Me · Jun 2013
Randomized Controlled Trial Comparative StudyUltrasound-guided radial artery catheterization in infants and small children.
To determine whether ultrasound guidance increases the success rates, decreases the complication rates, and shortens the time to successful radial artery catheterization in infants and small children. ⋯ In infants and small children, ultrasound-guided radial artery catheterization was more successful and expeditious than the usual palpation technique.
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Pediatr Crit Care Me · Jun 2013
ReviewClinical management of the extracorporeal membrane oxygenation circuit.
The clinical management of patients on extracorporeal membrane oxygenation should be standardized and follow clear guidelines or protocols. However, due to the diversity of cannulation strategies and the complex situations that extracorporeal membrane oxygenation is now used in, each extracorporeal membrane oxygenation program has developed its own clinical management strategies. These vary widely across the globe. ⋯ Improvements in technology and greater understanding of disease pathophysiology, coupled to refinements in technology, which lessen the adverse interaction between the circuit and the patient, all contribute to fewer mechanical and patient complications on extracorporeal membrane oxygenation. Earlier and more appropriate use of extracorporeal membrane oxygenation has been associated with improved patient outcomes. These clinical management strategies are reviewed in this article, part of the Pediatric Cardiac Intensive Care Society/Extracorporeal Life Support Organization Joint Statement on Mechanical Circulatory Support.