Abstract:
:Extracorporeal membrane oxygenation (ECMO) has been used for 20 years in neonates and children with cardiac and respiratory failure. The number of neonates treated with ECMO has increased exponentially, but the number of older children treated is small. The selection and exclusion criteria for pediatric ECMO are poorly defined, and the results vary because of variable selection criteria and institutional experience with the technique. In order to help define the role of pediatric ECMO, we reviewed our experience in noneonatal pediatric respiratory failure. We have treated 22 patients ranging in age from 1 to 105 months and ranging in weight from 3 to 35 kg. Eighteen patients met the criteria for adult respiratory distress syndrome, two had respiratory syncytial virus pneumonia, and one had severe barotrauma complicating the management of reactive airway disease. All patients were considered by the referring institutions and by us to be failing conventional management as evidenced by hypoxia, hypercarbia, excessive ventilatory pressures, or progressive barotrauma. All were considered likely to die with continued conventional management. Sixteen of the 22 patients had complications (73%), but half of the last 10 patients had no complications. Hemorrhagic complications occurred in 12 patients. Mechanical complications included membrane failure, raceway rupture, pump malfunction, and improper cannula positioning. Other complications included culture-proven infection and renal failure. Eleven of the 22 patients survived (50%); nine of the last 12 survived (75%). These results suggest that ECMO may be a useful technique in selected pediatric patients with respiratory failure. Survival and complication rates improve as experience with the technique increases.
journal_name
J Pediatr Surgjournal_title
Journal of pediatric surgeryauthors
Adolph V,Heaton J,Steiner R,Bonis S,Falterman K,Arensman Rdoi
10.1016/0022-3468(91)90511-qsubject
Has Abstractpub_date
1991-03-01 00:00:00pages
326-30; discussion 330-2issue
3eissn
0022-3468issn
1531-5037pii
0022-3468(91)90511-Qjournal_volume
26pub_type
杂志文章abstract::Acquired gastric outlet obstruction occurred in a neonate following gastrostomy, after surgery to salvage a dehisced primary repair of an esophageal atresia. Despite free drainage of the gastrostomy and total support of the neonate, the gastric outlet obstruction persisted and required a further operation. An anterogr...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(88)80400-7
更新日期:1988-10-01 00:00:00
abstract::The authors used a conservative approach to treat focal nodular hyperplasia of the liver (FNH) and were interested in the long-term results of different therapeutic approaches in order to establish the most appropriate treatment. A review of the literature was conducted, and 31 pediatric case reports were identified i...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/0022-3468(95)90162-0
更新日期:1995-11-01 00:00:00
abstract::In infants and children requiring prolonged and multiple central venous catheterizations, conventional cannulation sites may become thrombosed or stenotic, making inability to gain vascular access a life-threatening problem. The technique we use for the percutaneous placement of inferior vena caval tunneled silastic c...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(90)90341-6
更新日期:1990-06-01 00:00:00
abstract::Disenchantment with available techniques for specific diagnosis of intrathoracic pulmonary lesions in children has led us to explore the usefulness of thoracoscopy. We have performed this technique in nine patients ranging in age from 17 mo to 16 yr. The procedure is performed under intravenous anesthesia with the pat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(76)90093-2
更新日期:1976-10-01 00:00:00
abstract:BACKGROUND/PURPOSE:Thoracoscopic repair has recently been attempted in newborns with esophageal atresia (EA), but it remains unclear whether thoracoscopic dissection reduces pathological gastroesophageal reflux. We investigated the influence of a thoracoscopic approach on esophageal motor function in patients with EA. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.07.049
更新日期:2009-12-01 00:00:00
abstract::A simplified technique for the repair of gastroschisis without the need to excise the umbilicus or make a fascial incision has been developed. First, the abdominal wall is stretched and the viscera are reduced. Next, the skin and subcutaneous tissue are elevated from the fascia for 1.5 cm around the defect and the fas...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(86)80361-x
更新日期:1986-09-01 00:00:00
abstract:BACKGROUND:Anal fissure in children usually is treated by sitz baths, stool softeners, and analgesic ointments. However, some cases are intractable to the treatment. In recent years, it has been reported that nitric oxide donors such as local glyceryl-trinitrate (GTN) ointment causes a reversible chemical sphincterotom...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0022-3468(99)90318-4
更新日期:1999-12-01 00:00:00
abstract::Necrotizing fasciitis is a rapidly progressive soft tissue infection involving the skin, subcutaneous tissue, and superficial fascia. It is a rare entity in the pediatric population. The specific etiologic factors that contribute to the establishment of necrotizing fasciitis in children are not evident. It may occur a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.01.024
更新日期:2005-04-01 00:00:00
abstract::Rhabdomyoma is a rare benign tumor of striated muscle origin. Two distinct histologic groups, adult and fetal type, are recognized. So far only 66 cases of extracardiac rhabdomyomas (37 fetal and 29 adult) have been documented in the literature reviewed. The present report details a case of adult rhabdomyoma of the es...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(87)80490-6
更新日期:1987-11-01 00:00:00
abstract:PURPOSE:The aim of this study was to determine the risk of central line associated blood-stream infections (CLABSI) in neonatal gastroschisis patients, risk factors, outcomes, and financial implications. METHODS:The 2016 Healthcare Cost and Utilization Project (HCUP)'s kid's inpatient database (KID), a national databa...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2019.10.028
更新日期:2020-02-01 00:00:00
abstract::Testicular feminization (TF) is a syndrome due to androgen insensitivity. It occurs in a complete (CTF) and an incomplete (ITF) form. We have treated 21 patients with TF over the last 24 years. Eight patients presented because of ambiguous genitalia, seven presented as "females" with inguinal hernia and testes were fo...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(05)80110-1
更新日期:1992-06-01 00:00:00
abstract:BACKGROUND/PURPOSE:Chronic or recurring enterocolitis is a rare but perplexing complication of Hirschsprung's disease affecting especially patients with altered immune defense such as those with Down's syndrome. Sodium cromoglycate (SCG) is a nonabsorbable mast cell stabilizing agent that has been documented to be effe...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1053/jpsu.2001.24732
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND/PURPOSE:The aim of this study was to compare the size of the right internal jugular vein between neonates with congenital diaphragmatic hernia (CDH) who need extracorporeal membrane oxygenation (ECMO) and non-CDH neonates. The purpose also was to describe a method for cannulation of the right brachiocephalic...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章
doi:10.1053/jpsu.2002.32908
更新日期:2002-06-01 00:00:00
abstract:PURPOSE:Intussusception is one of the common causes of intestinal obstruction in early childhood. Although a genetic predisposition has been suggested in some cases, its etiology is considered to be incidental, and it has not been traditionally regarded as having any genetic basis. Authors report on cases of so-called ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2007.04.012
更新日期:2007-09-01 00:00:00
abstract::A term female newborn underwent uncomplicated repair of esophageal atresia with tracheoesophageal fistula (type C) then coarctation of the aorta. Subsequently, she developed symptomatic esophageal strictures, which required serial dilations. In addition, she suffered feeding intolerance from esophageal dysmotility and...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2010.09.010
更新日期:2011-01-01 00:00:00
abstract::Isolated sternal clefts are rare congenital anomalies. Complete clefts are rarer still with only 23 cases being reported. We present an adolescent girl with a complete sternal cleft. The cleft was treated with autologous anterior perichondrial flaps and pectoralis advancement flaps. ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2009.09.019
更新日期:2009-12-01 00:00:00
abstract:PURPOSE:To evaluate the effect of free vascularized fibula grafts on developing donor leg function, the authors reviewed their experience of procedures performed in children. METHODS:Over a 10-year period, 30 children (average age 7.2 years, without gender concern) underwent fibula harvest via an anterolateral approac...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1053/jpsu.2000.8759
更新日期:2000-08-01 00:00:00
abstract:PURPOSE:The aim of the study was to review the records of all children who presented with gastric volvulus in the past 10 years. METHODS:The study group consisted of 21 children with an age range from 0.2 months to 4.3 years who were operated for gastric volvulus from 1992 to 2003. RESULTS:Initial symptoms included a...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.01.057
更新日期:2005-05-01 00:00:00
abstract:AIM:The aim of the study was to evaluate the safety and outcomes of simultaneous bilateral thoracotomy in pediatric patients compared with traditional bilateral staged thoracotomy. METHODS:This is a retrospective review of 30 consecutive patients 18 years or younger undergoing either bilateral staged or bilateral simu...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2005.12.003
更新日期:2006-04-01 00:00:00
abstract::This study reviews our experience from 1977 to 1991 with 32 children born with esophageal atresia and tracheoesophageal fistula (EA-TEF) who later underwent surgery for severe tracheomalacia. Indications for surgery included dying spells (21), inability to extubate the airway (nasotracheal tube 5, tracheotomy 3), and ...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(92)90575-r
更新日期:1992-08-01 00:00:00
abstract:BACKGROUND:Reconstructive surgery is performed in patients with cloacal malformations to achieve anorectal, urological, and gynecological function. The aim of this study was to evaluate the functional outcome of cloacal malformation repair as reported in literature. METHODS:A systematic literature search was conducted...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jpedsurg.2013.08.027
更新日期:2013-11-01 00:00:00
abstract::There are few reported cases of acute portal vein thrombosis presenting as an acute abdomen in adolescent age group. Most published series concern chronic extrahepatic portal vein thrombosis. Acute portal vein thrombosis is rare, but can develop into serious complications. Hence, prompt diagnosis and heparinization ca...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/0022-3468(93)90140-g
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND/PURPOSE:The management of patients with a giant omphalocele remains a difficult problem. In this study, the authors described a new surgical approach for delayed closure of ventral hernia--the Lazaro da Silva's technique--in conservatively treated patients. METHODS:Ventral hernias of 11 conservatively treat...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2004.03.064
更新日期:2004-07-01 00:00:00
abstract:BACKGROUND:Although surgical interventions for intestinal atresia are usually successful, oral feed intolerance could raise in certain cases. The aim of this study was to identify the factors that affect postoperative oral feed by retrospective analysis. METHODS:Neonates meeting the inclusion criteria, who were admitt...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2014.06.010
更新日期:2014-11-01 00:00:00
abstract:AIM:Antenatal screening has led to early detection of posterior urethral valves (PUV). However, despite early intervention, a proportion of children will develop chronic renal insufficiency. We studied the trend of serum creatinine following urinary tract decompression during the neonatal period in infants as a possibl...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2012.11.016
更新日期:2013-02-01 00:00:00
abstract::Several factors suggested to predict mortality in congenital diaphragmatic hernia (CDH) have not always been applicable in different centers. A retrospective review was conducted of 19 consecutive neonates in Singapore in whom CDH was diagnosed within 12 hours of birth to identify factors associated with mortality. Of...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(97)90104-4
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND/PURPOSE:Considerable debate surrounds the choice of technique for the removal of esophageal coins: endoscopic extraction versus dislodgement with a Foley balloon versus dislodgement using bougienage. The "penny-pincher" (PP) technique was developed as an alternative, incorporating the main advantages of thes...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/s0022-3468(00)90024-1
更新日期:2000-02-01 00:00:00
abstract:BACKGROUND/PURPOSE:Laparoscopic Appendectomy (LA) is a safe procedure in adults resulting in shorter hospitalization and sooner return to activity. The relative merits of LA and open appendectomy (OA) are evaluated in this first prospective and randomized study in children. METHODS:A total of 129 children with appendi...
journal_title:Journal of pediatric surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1053/jpsu.2002.30841
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND/PURPOSE:The purpose of the study was to review our experience in the re-operative management of anastomotic complications (ACs) following primary repair of esophageal atresia (EA) and tracheoesophageal fistula (TEF) and to assess the outcomes after reoperation. METHODS:We retrospectively reviewed 21 EA pati...
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.08.015
更新日期:2015-12-01 00:00:00
abstract:BACKGROUND:A variety of prosthetic materials are used in the pediatric population for abdominal and chest wall reconstruction. Pediatric experience of non-cross-linked porcine acellular dermal matrix is limited to patients following liver transplantation. We review our outcomes in patients in whom this matrix was used....
journal_title:Journal of pediatric surgery
pub_type: 杂志文章
doi:10.1016/j.jpedsurg.2015.10.083
更新日期:2016-03-01 00:00:00