Pediatric and neonatal extracorporeal life support: current state and continuing evolution

The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of...

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Published inPediatric surgery international Vol. 37; no. 1; pp. 17 - 35
Main Authors Fallon, Brian P., Gadepalli, Samir K., Hirschl, Ronald B.
Format Journal Article
LanguageEnglish
Published Berlin/Heidelberg Springer Berlin Heidelberg 01.01.2021
Springer Nature B.V
Subjects
Child
Child, Preschool
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - methods
Extracorporeal Membrane Oxygenation - trends
Humans
Infant
Infant, Newborn
Medicine
Medicine & Public Health
Newborn babies
Pediatric Surgery
Pediatrics
Pediatrics - methods
Review
Review Article
Surgery
Neonatal
Respiratory failure
Pediatric
Extracorporeal membrane oxygenation (ECMO)
Extracorporeal life support (ECLS)
Online AccessGet full text
ISSN0179-0358
1437-9813
1437-9813
DOI10.1007/s00383-020-04800-2

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Abstract The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.
AbstractList The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.
The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic improvements in the technology and safety of ECLS that have broadened the scope of its application. This article will review the evolving landscape of ECLS, including its expanding indications and shrinking contraindications. It will also describe traditional and hybrid cannulation strategies as well as changes in circuit components such as servo regulation, non-thrombogenic surfaces, and paracorporeal lung-assist devices. Finally, it will outline the modern approach to managing a patient on ECLS, including anticoagulation, sedation, rehabilitation, nutrition, and staffing.
Author Gadepalli, Samir K.
Fallon, Brian P.
Hirschl, Ronald B.
Author_xml – sequence: 1
  givenname: Brian P.
  surname: Fallon
  fullname: Fallon, Brian P.
  email: bfallon@med.umich.edu
  organization: Department of Surgery, ECLS Laboratory, B560 MSRB II/SPC 5686, Michigan Medicine, University of Michigan
– sequence: 2
  givenname: Samir K.
  surname: Gadepalli
  fullname: Gadepalli, Samir K.
  organization: Department of Surgery, Section of Pediatric Surgery, University of Michigan
– sequence: 3
  givenname: Ronald B.
  surname: Hirschl
  fullname: Hirschl, Ronald B.
  organization: Department of Surgery, Section of Pediatric Surgery, University of Michigan
BackLink https://www.ncbi.nlm.nih.gov/pubmed/33386443$$D View this record in MEDLINE/PubMed
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Issue 1
Keywords Neonatal
Respiratory failure
Pediatric
Extracorporeal membrane oxygenation (ECMO)
Extracorporeal life support (ECLS)
Language English
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Snippet The use of extracorporeal life support (ECLS) for the pediatric and neonatal population continues to grow. At the same time, there have been dramatic...
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StartPage 17
SubjectTerms Child
Child, Preschool
Extracorporeal membrane oxygenation
Extracorporeal Membrane Oxygenation - methods
Extracorporeal Membrane Oxygenation - trends
Humans
Infant
Infant, Newborn
Medicine
Medicine & Public Health
Newborn babies
Pediatric Surgery
Pediatrics
Pediatrics - methods
Review
Review Article
Surgery
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Title Pediatric and neonatal extracorporeal life support: current state and continuing evolution
URI https://link.springer.com/article/10.1007/s00383-020-04800-2
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Volume 37
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