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Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program

  • Erin Cicalese ORCID logo EMAIL logo , Sarah Meisler , Michael Kitchin , Margaret Zhang , Sourabh Verma , Heda Dapul , Jaclyn McKinstry , Bridget Toy , Arun Chopra and Jason C. Fisher
Published/Copyright: December 13, 2022
Journal of Perinatal Medicine
From the journal Journal of Perinatal Medicine Volume 51 Issue 5

Abstract

Objectives

We aimed to critically evaluate the effectiveness of a designated ECMO team in our ECMO selection process and patient outcomes in the first 3 years of our low-volume pediatric ECMO program.

Methods

We conducted a retrospective chart review of patients who received an ECMO consultation between the start of our program in March 2015 and May 2018. We gathered clinical and demographic information on patients who did and did not receive ECMO, and described our selection process. We reflected on the processes used to initiate our program and our outcomes in the first 3 years.

Results

Sixty-nine patients received consultations, and of those, 50 patients were potential candidates. 19 (38%) of the candidates were ultimately placed on ECMO. There were statistically significant differences in oxygen saturation, paO2, oxygenation index, A-aDO2, lactate, and pH between the patients who went on ECMO and who did not. We improved our outcomes from 0% survival to discharge in 2015, to 60% in 2018, with an average of 63% survival to discharge over the first 3 years of our program.

Conclusions

In a low-volume pediatric ECMO center, having a designated team to assist in the patient selection process and management can help provide safe and efficient care to these patients, and improve patient outcomes. Having a strict management protocol and simulation sessions involving all members of the medical team yields comfort for the providers and optimal care for patients. This study describes our novel structure, processes, and outcomes, which we hope will be helpful to others seeking to develop a new pediatric ECMO program.

Keywords: cannulation; extracorporeal membrane oxygenation; medical decision making; pediatric ECMO
Corresponding author: Erin Cicalese, MD, Assistant Professor of Pediatrics, Attending Neonatologist, Department of Pediatrics, NYU Grossman School of Medicine, Hassenfeld Children’s Hospital at NYU Langone, 317 East 34th Street, Suite 902, New York, NY 10016, USA, E-mail:

Funding source: This study was funded in part by the Jack Carey Eichenbaum Memorial Scholarship Fund

  1. Research funding: This study was funded in part by the Jack Carey Eichenbaum Memorial Scholarship Fund.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  3. Competing interests: Authors state no conflict of interest.

  4. Informed consent: N/A, as this was a retrospective chart review, as per the local Institutional Review Board.

  5. Ethical approval: This study was Institutional Review Board (IRB) approved and met the IRB standards of ethical conduction of research.

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Received: 2022-06-22
Accepted: 2022-11-22
Published Online: 2022-12-13
Published in Print: 2023-06-27

© 2022 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/jpm-2022-0298
Keywords for this article
cannulation; extracorporeal membrane oxygenation; medical decision making; pediatric ECMO

Articles in the same Issue

  1. Frontmatter
  2. Reviews
  3. Disquiet concerning cesarean birth
  4. Prenatal care and pregnancy outcome among incarcerated pregnant individuals in the United States: a systematic review and meta-analysis
  5. Corner of Academy
  6. Does COVID-19 infection acquired in different pregnancy trimester influence placental pathology?
  7. Original Articles – Obstetrics
  8. Did the first wave of the COVID-19 pandemic impact the cesarean delivery rate? A retrospective cohort study at a primary care center in Switzerland
  9. Hypertensive disorders of pregnancy and severe acute respiratory syndrome coronavirus-2 infection
  10. Hidden in plain sight in the delivery room – the Apgar score is biased
  11. Comparison of phase rectified signal averaging and short term variation in predicting perinatal outcome in early onset fetal growth restriction
  12. Serum levels of kynurenine in pregnancies with fetal growth restriction and oligohydramnios
  13. Effect of third trimester maternal vitamin D levels on placental weight to birth weight ratio in uncomplicated pregnancies
  14. One-third of patients with eclampsia at term do not have an abnormal angiogenic profile
  15. Chorioangioma: a single tertiary care center retrospective study
  16. A prospective cohort study: can advanced ultrasonography replace magnetic resonance imaging in the diagnosis of placental adhesion disorders?
  17. Original Articles – Fetus
  18. Fetal left brachiocephalic vein diameters in normal and growth restricted fetuses
  19. Functional assessment of atrial wall excursion and foramen ovale flap tracings in 3rd trimester as predictor of short-term hemodynamic stability in congenital heart defects fetuses
  20. Original Articles – Neonates
  21. Developing a new pediatric extracorporeal membrane oxygenation (ECMO) program
  22. Patterns of placental injury in various types of fetal congenital heart disease
  23. Short Communication
  24. Prenatal care in the era of economic collapse
  25. Letters to the Editor
  26. Does fetus feel stress or pain on uterine contraction?
  27. Pregnancy associated plasma protein-A for the prediction of small for gestational age
  28. Reply to: Pregnancy associated plasma protein-A for the prediction of small for gestational age
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