Skip to main content
SpringerLink
Log in

Extracorporeal Membrane Oxygenation in Children

  • Chapter
Assisted Circulation 4

Abstract

The introduction of modern methods of prolonged extracorporeal life support to the United Kingdom (UK) commenced in Leicester in 1989 [1]. Up to that time, many cardiothoracic centres had had prior experience of its use, usually in the treatment of adults, dating from the late 1970s [2, 3]. The universally poor outlook for such patients, documented by the National Institutes of Health (NIH) trial in 1979 [4], caused most to abandon its use. However, extracorporeal membrane oxygenation (ECMO) had become so successful in the treatment of neonates during the 1980s, in the United States of America [5], as to become considered a standard therapy. This was the stimulus for us to start our service. In the light of more recent experience in older patients [6], we did not confine the facility to neonates, but considered any patient with a potentially reversible pulmonary or cardiopulmonary problem.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sosnowski AW, Bonser SJ, Field DJ, Graham TR, Firmin RK (1990) Extracorporeal membrane oxygenation. Br Med J 301:303–304

    Article  CAS  Google Scholar 

  2. Hill JD, O’Brien TG, Murray JJ, Dontigny L, Bramson ML, Osborn JJ, Gerbode F (1972) Prolonged extracorporeal oxygenation for acute post-traumatic respiratory failure (shock-lung syndrome). Use of the Bramson membrane lung. N Eng J Med 286:629–634

    Article  CAS  Google Scholar 

  3. Hill JD, DeLeval M, Fallat RJ, Bramson ML, Eberhart RC, Schulte HD, Osborn JJ, Barber R, Gerbode F (1972) Acute respiratory insufficiency. Treatment with prolonged extracorporeal oxygenation. J Thorac Cardiovasc Surg 64:551–562

    PubMed  CAS  Google Scholar 

  4. Zapol WM, Snider MT, Hill JD, Fallat RJ, Bartlett RH, Edmunds LH, Morris AH, Peirce E. 2nd, Thomas AN, Proctor HJ, Drinker PA, Pratt PC, Bagniewski A, Miller RJ (1979) Extracorporeal membrane oxygenation in severe acute respiratory failure. A randomized prospective study. J Am Med Assoc 242:2193–2196

    Article  CAS  Google Scholar 

  5. Bartlett RH, Gazzaniga AB, Toomasian J, Coran AG, Roloff D, Rucker R, Corwin AG (1986) Extracorporeal membrane oxygenation (ECMO) in neonatal respiratory failure. 100 cases [published erratum appears in Ann Surg 1987 205:11A]; Ann Surg 204:236–245

    Article  PubMed  CAS  Google Scholar 

  6. Pesenti A, Gattinoni L, Kolobow T, Damia G (1988) Extracorporeal circulation in adult respiratory failure. ASAIO Trans 34:43–47

    PubMed  CAS  Google Scholar 

  7. Yoshinaga N et al. (1966) Application of assisting extracorporeal circulation to a patient with severe carbon dioxide intoxication. Masui 15:1041–1043

    Google Scholar 

  8. Kolobow T, Hayano F, Weathersby PK (1975) Dispersion-casting thin and ultrathin fabric- reinforced silicone rubber membrane for use in the membrane lung. Med Instrum (Baltimore) 9:124–128

    PubMed  CAS  Google Scholar 

  9. Lande AJ, Dos SJ, Carlson RG, Perschau RA, Lange RP, Sonstegard LJ, Lillehei CW (1967) A new membrane oxygenator-dialyzer. Surg Clin North Am 47:1461–1470

    PubMed  CAS  Google Scholar 

  10. Ed: Arensman RM, Devn-Cornish J (1993) Extracorporeal life support. Blackwell Scientific, Boston

    Google Scholar 

  11. Bartlett RH (1990) Extracorporeal life support for cardiopulmonary failure. Curr Probl Surg 27:621–705

    Article  PubMed  CAS  Google Scholar 

  12. Toomasian JM, Snedecor SM, Cornell RG, Cilley RE, Bartlett RH (1988) National experience with extracorporeal membrane oxygenation for newborn respiratory failure. Data from 715 cases. ASAIO Trans 34:140–147

    Article  PubMed  CAS  Google Scholar 

  13. Data Supplied by the Registry of the Extracorporeal Life Support Organisation

    Google Scholar 

  14. Kolobow T (1988) Acute respiratory failure: on how to injure healthy lungs (and prevent sick lungs from recovering. ASAIO Trans 34:31–34

    PubMed  CAS  Google Scholar 

  15. Kimball TR, Weiss RG, Meyer RA, Daniels SR, Ryckman FC, Schwartz DC (1989) Color flow mapping to document normal pulmonary venous return in neonates with persistent pulmonary hypertension being considered for extracorporeal membrane oxygenation. J Pediatr 114:433–437

    Article  PubMed  CAS  Google Scholar 

  16. Zylberberg R, Cook L, Roberts J, Edmonds D, Reese A, Groff D (1987) Total anomalous pulmonary venous return: report of a case diagnosed on ECMO. J Perinatol 7:185–185

    PubMed  CAS  Google Scholar 

  17. Pearson GA, Sosnowski A, Firmin RK, Leanage R (1992) Extracorporeal membrane oxygenation and cyanotic heart disease. Cardiology in the Young 2:359–360

    Article  Google Scholar 

  18. Wetmore N, McEwen D, O’Connor M, Bartlett RH (1979) Defining indications for artificial organ support in respiratory failure. ASAIO Trans 25:459–461

    Article  CAS  Google Scholar 

  19. Hallman M, Merritt TA, Jarvenpaa AL, Boynton B, Mannino F, Gluck L, Moore T, Edwards D (1985) Exogenous human surfactant for treatment of severe respiratory distress syndrome: a randomised prospective clinical trial. J Pediatr 106:963–969

    Article  PubMed  CAS  Google Scholar 

  20. Bohn DJ, James I, Filler RM, Ein SH, Wesson DE, Shandling B, Stephens C, Barker GA (1984) The relationship between PaCO2 and ventilation parameters in predicting survival in congenital diaphragmatic hernia. J Pediatr Surg 19:666–671

    Article  PubMed  CAS  Google Scholar 

  21. Rivera RA, Butt W, Shann F (1990) Predictors of mortality in children with respiratory failure: possible indications for ECMO Anaesth Intensive Care 18:385–389

    CAS  Google Scholar 

  22. Timmons OD, Dean JM, Vernon DD (1991) Mortality rates and prognostic variables in children with adult respiratory distress syndrome. J Pediatr 119:896–899

    Article  PubMed  CAS  Google Scholar 

  23. Pratt PC, Vollmer RT, Shelburne JD, Crapo JD (1979) Pulmonary morphology in a multihospital collaborative extracorporeal membrane oxygenation project. I. Light microscopy. Am J Pathol 95:191–214

    PubMed  CAS  Google Scholar 

  24. Pearson GA, Underwood MJ, Chan KC, Firmin RK (1993) Extracorporeal membrane oxygenation and paediatric cardiology. Cardiology in the Young 3:197–201

    Article  Google Scholar 

  25. Montoya JP, Merz SI, Bartlett RH (1991) A standardized system for describing flow/pressure relationships in vascular access devices. ASAIO Trans 37:4–8

    Article  PubMed  CAS  Google Scholar 

  26. Pearson GA, Sosnowski A, Chan KC, Firmin RK (1993) Salvage of postoperative pulmonary hypertensive crists using ECMO via cervical cannulation. Eur J Cardiothorac Surg 7:390–391

    Article  PubMed  CAS  Google Scholar 

  27. Kinsella JP, Gerstmann DR, Rosenberg AA (1992) The effect of extracorporeal membrane oxygenation on coronary perfusion and regional blood flow distribution. Pediatr Res 31:80–84

    Article  PubMed  CAS  Google Scholar 

  28. Morigami K, Yamada C, Shiokawa C, Ohno K, Maekawa Y, Kinoshita H (1990) Experimental studies on extracorporeal membrane oxygenation (ECMO) perfusion for respiratory insufficiency associated with pulmonary hypertension (in Japanese). Nippon Geka Gakkai Zasshi 91:272–282

    PubMed  CAS  Google Scholar 

  29. Bartlett RH, Cilley RE (1993) Physiology of extracorporeal life support. In: Arensman RM Cornish JD (eds) Extracorporeal lief support. Blackwell Scientific, Boston, pp 89–104

    Google Scholar 

  30. Gattinoni L, Pesenti A, Mascheroni D, Marcolin R, Fumagalli R, Rossi F, Lapichino G, Romagnoli G, Uziel L, Agostoni A et al. (1986) Low-frequency positive-pressure ventilation with extracorporeal CO2 removal in severe acute respiratory failure. J Am Med Assoc 256:881–886

    Article  CAS  Google Scholar 

  31. Berdjis F, Takahashi M, Lewis AB (1992) Left ventricular performance in neonates on extracorporeal membrane oxygenation. Pediatr Cardiol 13:141–145

    PubMed  CAS  Google Scholar 

  32. Axelrod HI, Baumann FG, Galloway AC (1989) Left ventricular stress during extracorporeal membrane oxygenation. Ann Thorac Surg 47:330 (letter)

    Article  PubMed  CAS  Google Scholar 

  33. Bavaria JE, Furukawa S, Kreiner G, Gupta KB, Streicher J, Edmunds LJ (1990) Effect of circulatory assist devices on stunned myocardium. Ann Thorac Surg 49:123–128

    Article  PubMed  CAS  Google Scholar 

  34. Burch KD, Covitz W, Lovett EJ, Howell C, Kanto WJ (1989) The significance of ductal shunting during extracorporeal membrane oxygenation. J Pediatr Surg 24:855–859

    Article  PubMed  CAS  Google Scholar 

  35. Westaby S (1987) Organ dysfunction after cardiopulmonary bypass. A systemic influammatory reaction initiated by the extracorporeal circuit. Intensive Care Med 13:89–95

    Article  PubMed  CAS  Google Scholar 

  36. Keszler M, Subramanian KN, Smith YA, Dhanireddy R, Mehta N, Molina B, Cox CB, Moront MG (1989) Pulmonary management during extracorporeal membrane oxygenation. Crit Care Med 17:495–500

    Article  PubMed  CAS  Google Scholar 

  37. Keszler M, Ryckman FC, McDonald JJ, Sweet LD, Moront MG, Boegli MJ, Cox C, Leftridge CA (1992) A prospective, multicenter, randomized study of high versus low positive end-expiratory pressure during extracorporeal membrane oxygenation. J Pediatr 120:107–113

    Article  PubMed  CAS  Google Scholar 

  38. Johnston PW, Liberman R, Gangitano E, Vogt J (1990) Ventilation parameters and arterial blood gases as a prediction of hypoplasia in congenital diaphragmatic hernia. J Pediatr Surg 25:496–499

    Article  PubMed  CAS  Google Scholar 

  39. Stolar C, Dillon P, Reyes C (1988) Selective use of extracorporeal membrane oxygenation in the management of congential diaphragmatic hernia. J Pediatr Surg 23:207–211

    Article  PubMed  CAS  Google Scholar 

  40. Hagen PT, Scholz DG, Edwards WD (1984) Incidence and size of patent foramen ovale during the first ten decades of life: an autopsy study of 965 normal hearts. Mayo Clin Proc 59:17–20

    PubMed  CAS  Google Scholar 

  41. Adolph V, Ekelund C, Smith C, Starrett A, Falterman K, Arensman R (1990) Developmental outcome of neonates treated with extracorporeal membrane oxygenation. J Pediatr Surg 25:43–46

    Article  PubMed  CAS  Google Scholar 

  42. Glass P, Miller M, Short B (1989) Morbidity for survivors of extracorpreal membrane oxygenation: neurodevelopmental outcome at 1 year of age. Pediatrics 83:72–78

    PubMed  CAS  Google Scholar 

  43. Hofkosh D, Thompson AE, Nozza RJ, Kemp SS, Bowen A, Feldman HM (1991) Ten years of extracorporeal membrane oxygenation: neurodevelopmental outcome. Pediatrics 87:549–555

    PubMed  CAS  Google Scholar 

  44. Brett C, Dekl M, Leonard PD et al. (1981) Developmental outcome of hyperventilated neonates: preliminary observations. Pediatrics 65:588–591

    Google Scholar 

  45. Rupreht J, Dworacek B (1990) Central anticholinergic syndrome during postoperative period. Ann Fr Anesth Reanim 9:295–304

    Article  PubMed  CAS  Google Scholar 

  46. Schneck HJ, Rupreht J (1989) Central anticholinergic syndrome (CAS) in anesthesia and intensive care. Acta Anaesth Belg 40:219–228

    PubMed  CAS  Google Scholar 

  47. Elliott SJ (1991) Neonatal extracorporeal membrane oxygenation: how not to assess novel technologies (see comments). Lancet 337:476–478

    Article  PubMed  CAS  Google Scholar 

  48. Greenough A, Emery E (1990) ECMO and outcome of mechanical ventilation in infants of birthweight over 2 kg. Lancet 336:760 [letter]

    Article  PubMed  CAS  Google Scholar 

  49. Anonymous (1988) Persistent fetal circulation and extracorporeal membrane oxygenation (editorial) (see comments). Lancet 2:1289–1291

    Google Scholar 

  50. Lantos JD, Frader J (1990) Extracorporeal membrane oxygenation and the ethics of clinical research in pediatrics (see comments). N Engl J Med 323:409–413

    Article  PubMed  CAS  Google Scholar 

  51. Bartlett RH, Roloff DW, Cornell RG, Andrews AF, Dillon PW, Zwischenberger JB (1985) Extracorporeal circulation in neonatal respiratory failure: a prospective randomized study. Pediatrics 76:479–487

    PubMed  CAS  Google Scholar 

  52. O’Rourke P, Crone RK, Vacanti JP, Ware JH, Lillehei CW, Parad RB, Epstein MF (1989) Extracorporeal membrane oxygenation and conventional medical therapy in neonates with persistent pulmonary hypertension of the newborn: a prospective randomized study. Pediatrics 84:957–963

    PubMed  Google Scholar 

  53. Pesenti A, Kolobow T, Gattinoni L (1988) Extracorporeal respiratory support in the adult. ASAIO Trans 34:1006–1008

    PubMed  CAS  Google Scholar 

  54. Anderson H III, Delius RE, Sinard JM, McCurry KR, Shanley CJ, Chapman RA, Shapiro MB, Rodriguez JL, Bartlett RH (1992) Early experience with adult extracorporeal membrane oxygenation in the modern era (see comments). Ann Thorac Surg 53:553–563

    Article  PubMed  Google Scholar 

  55. Suchyta MR, Clemmer TP, Orme JJ, Morris AH, Elliott CG (1991) Increased survival of ARDS patients with severe hypoxemia (ECMO criteria). Chest 99:951–955

    Article  PubMed  CAS  Google Scholar 

  56. Vasilyev S, McMillan S, Schaap R, Mortenson JD (1992) Survival rates for patients with acute respiratory failure in 1991–1992, utilizing mechanical ventilator augmentation of blood gas transfer. A multicenter prospective survey. Proc ledings of the 2nd Congress of the European Extracorporeal Support Organisation, Marburg, 1992, L30

    Google Scholar 

  57. Sittig DF, Gardner RM, Pace NL, Morris AH, Beck E (1989) Computerized management of patient care in a complex, controlled clinical trial in the intensive care unit. Compute Methods Programs Biomed 30:77–84

    Article  CAS  Google Scholar 

  58. Sittig DF, Gardner RM, Morris AH, Wallace CJ (1990) Clinical evaluation of computer-based respiratory care algorithms. Int J Clin Monit Comput 7:177–185

    Article  PubMed  CAS  Google Scholar 

  59. Rose SJ (1990) Extracorporeal membrane oxygenation (letter; comment). Br Med J 301:1163

    Google Scholar 

  60. Eberhart RC (1993) Interactions of blood and artificial surfaces: in search of “heparin-free” cardiopulmonary bypass. In: Arensman RM, Cornish JD (eds) Extracorporeal life support. Blackwell Scientific, Boston, pp 105–125

    Google Scholar 

  61. Mammen EF, Koets MH, Washington BC et al. (1985) Haemostasis changes during cardiopulmonary bypass surgery. Semin Thromb Hemost 11:281–292

    Article  PubMed  CAS  Google Scholar 

  62. Chenoweth DE, Cooper SW, Hugli TE (1981) Complement activation during cardiopulmonary bypass. N Engl J Med 304:497–503

    Article  PubMed  CAS  Google Scholar 

  63. Stibbe J, Kluft C, Brommer EJ (1984) Enhanced fibrinolytic activity after cardiopulmonary bypass surgery in man is caused by extrinsic (tissue type) plasminogen activator. Eur J Clin Invest 14:375

    Article  PubMed  CAS  Google Scholar 

  64. Fuhrer G, Gallimore MJ, Heller W (1984) Studies on the components of the plasma kallikreinkinin system in patients undergoing cardiopulmonary bypass. In: Greenbaum LW, Margolis HS (eds) Kinins IV: advances in experimental medicine and biology. Plenum, New York, pp 53–61

    Google Scholar 

  65. Westaby S (1987) Aspects of biocompatability in cardiopulmonary bypass. CRC Crit Rev Biocompat 3:193–234

    CAS  Google Scholar 

  66. Bindslev L (1988) Adult ECMO performed with surface-heparinized equipment. ASAIO Trans 34:1009–1013

    PubMed  CAS  Google Scholar 

  67. Toomasian JM, Hsu LC, Hirschl RB, Heiss KF, Hultquist KA, Bartlett RH (1988) Evaluation of Durafïo II heparin coating in prolonged extracorporeal membrane oxygenation. ASAIO Trans 34:410–414

    Article  PubMed  CAS  Google Scholar 

  68. Luscher TF (1991) Endothelium-derived nitric oxide: the endogenous nitrovasodilator in the human cardiovascular system. Eur Heart J 12:2–11

    PubMed  Google Scholar 

  69. Beckman JS, Beckman TW, Chen J, Marshall PA, Freeman BA (1990) Apparent hydroxyl radical production by peroxynitrite: implications for endothelial injury from nitric oxide and superoxide. Proc Natl Acad Sci USA 87:1620–1624

    Article  PubMed  CAS  Google Scholar 

  70. Kinsella JP, Neish SR, Shaffer E, Abman SH (1992) Low-dose inhalation nitric oxide in persistent pulmonary hypertension of the newborn (see comments). Lancet 340:819–820

    Article  PubMed  CAS  Google Scholar 

  71. Roberts JD, Polaner DM, Lang P, Zapol WM (1992) Inhaled nitric oxide in persistent pulmonary hypertension of the newborn (see comments). Lancet 340:818–819

    Article  PubMed  CAS  Google Scholar 

  72. Urbaniak SJ (1991) Artificial blood. Br Med J 303:1348–1350

    Article  CAS  Google Scholar 

  73. Leach CL, Fuhrmann BP, Morin FC, Rath MG (1993) Perfluorocarbon-associated gas exchange (partial liquid ventilation) in respiratory distress syndrome: a prospective randomized controlled study. Crit Care Med 21:1270–1278

    Article  PubMed  CAS  Google Scholar 

  74. Mortenson JD, Berry G (1989) Conceptual and design features of a practical, clinically effective intravenous mechanical oxygen/carbon dioxide exchange device (IVOX). Int J Artif Organs 12:384–389

    Google Scholar 

  75. High KM, Snider MT, Richard R, Russell GB, Stene JK, Campbell DB (1992) Clinical trials of an intravenous oxygenator in patients with adult respiratory distress syndrome. Anesthesiology 77:856–863

    Article  PubMed  CAS  Google Scholar 

  76. Conrad SA, Eggerstedt JM, Morris VF, Romero MD (1993) Prolonged intracorporeal support of gas-exchange with an intravenacaval oxygenator. Chest 103:158–161

    Article  PubMed  CAS  Google Scholar 

  77. Kallis P, al-Saady, NM, Bennett ED, Treasure T (1993) Early results of intravascular oxygenation. Eur J Cardiothorac Surg 7:206–210

    Article  PubMed  CAS  Google Scholar 

  78. Hawking S (1988) The uncertainty principle. In: A brief history of time from the big bang to black holes. Transworld, London, pp 53–62

    Google Scholar 

  79. Gleick J (1987) A geometry of nature. In: Chaos. Sphere, London, pp 81–118

    Google Scholar 

Download references

Authors
  1. G. A. Pearson
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. R. K. Firmin
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Herzchirurgie Salzburg Landeskrankenanstalten, Müllner Hauptstr. 48, A-5020, Salzburg, Austria

    Felix Unger

Rights and permissions

Reprints and permissions

Copyright information

© 1995 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Pearson, G.A., Firmin, R.K. (1995). Extracorporeal Membrane Oxygenation in Children. In: Unger, F. (eds) Assisted Circulation 4. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-79340-0_30

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-79340-0_30

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-79342-4

  • Online ISBN: 978-3-642-79340-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation