Extracorporeal life support for pediatric respiratory failure.


OBJECTIVES:The purposes of this report are to a) describe the University of Michigan experience with venoarterial or venovenous extracorporeal life support for severe pediatric pulmonary rescue therapy, and b) examine survivors and nonsurvivors for differences that might be useful for examination in future, prospective studies. DESIGN:Case series report. Phase I study of safety and effectiveness of extracorporeal life support for pediatric respiratory failure. SETTING:University of Michigan Medical Center. PATIENTS:Non-neonatal pediatric patients treated with extracorporeal life support for severe respiratory failure at the University of Michigan. INTERVENTIONS:Extracorporeal life support for pulmonary failure. MEASUREMENTS AND MAIN RESULTS:From November 1982 until May 1991, 25 pediatric patients underwent extracorporeal life support for severe pulmonary failure. Twenty patients were treated in the last 36 months. Sixty percent (15/25 patients) survived their life-threatening respiratory illness, were weaned from mechanical ventilation, and were discharged home. The mean patient age was 4.1 yrs, and mechanical ventilation duration before extracorporeal life support was 5.9 days. Mean blood gas data and mechanical ventilation pressures before extracorporeal life support were: peak inspiratory pressure of 48.6 cm H2O, mean airway pressure of 21.9 cm H2O, positive end-expiratory pressure of 9.7 cm H2O, PaCO2 of 43 torr (5.7 kPa), PaO2 of 69 torr (9.1 kPa), estimated alveolar-arterial oxygen gradient of 563 torr (75 kPa), and FIO2 of 0.98. Variables associated with survival included: age of survivors vs. nonsurvivors, 2.1 vs. 7.1 yrs (p less than .02); peak inspiratory pressure of survivors vs. nonsurvivors, 43.1 vs. 57.9 cm H2O (p less than .03); mean airway pressure of survivors vs. nonsurvivors, 18.4 vs. 27.2 cm H2O (p less than .03); and positive end-expiratory pressure of survivors vs. nonsurvivors, 8.1 vs. 12.1 cm H2O (p less than .01). There were no differences detectable in the blood gas values (PaO2, PaCO2, P[A-a]O2) in survivors and nonsurvivors before extracorporeal life support. The number of days mechanical ventilation was used before extracorporeal life support in survivors and in nonsurvivors was similar. CONCLUSION:Extracorporeal life support is an effective rescue therapy for pediatric patients with severe respiratory failure (University of Michigan survival rate of 60%).


Crit Care Med


Critical care medicine


Moler FW,Custer JR,Bartlett RH,Palmisano J,Meliones JN,Delius RE,Braden EI,Snedecor S




Has Abstract


1992-08-01 00:00:00












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    pub_type: 杂志文章,多中心研究


    authors: Nagaraj SB,McClain LM,Zhou DW,Biswal S,Rosenthal ES,Purdon PL,Westover MB

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  • Somatosensory and brainstem auditory evoked potentials in cardiac arrest patients treated with hypothermia.

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    journal_title:Critical care medicine

    pub_type: 临床试验,杂志文章,随机对照试验


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    pub_type: 杂志文章


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    更新日期:2004-11-01 00:00:00

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: du Toit HJ,Coetzee AR,Chalton DO

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    journal_title:Critical care medicine

    pub_type: 杂志文章,评审


    authors: Haglund U

    更新日期:1993-02-01 00:00:00

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    pub_type: 杂志文章


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    更新日期:2017-08-01 00:00:00

  • Impact of Proactive Nurse Participation in ICU Family Conferences: A Mixed-Method Study.

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    更新日期:2016-06-01 00:00:00

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Kudchadkar SR,Nelliot A,Awojoodu R,Vaidya D,Traube C,Walker T,Needham DM,Prevalence of Acute Rehabilitation for Kids in the PICU (PARK-PICU) Investigators and the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


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  • Simultaneous monitoring of transcutaneous blood gases and heart-rate variability in neonates.

    abstract::Instantaneous heart rate, indices of long-term and short-term heart-rate variability (HRV), and transcutaneous O2 (PtcO2) and CO2 (PtcCO2) tensions were recorded simultaneously on 164 occasions in 16 neonates. There was significant inverse correlation between PtcCO2 and both HRV indices, while no linear correlation wa...

    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Aärimaa T,Kero P,Välimäki I

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    authors: Pollack MM,Ruttimann UE,Getson PR

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    journal_title:Critical care medicine

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    pub_type: 临床试验,杂志文章


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    更新日期:2003-01-01 00:00:00

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    journal_title:Critical care medicine

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    authors: Rubenfeld GD

    更新日期:2009-01-01 00:00:00

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    journal_title:Critical care medicine

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    authors: Schwarz B,Mair P,Margreiter J,Pomaroli A,Hoermann C,Bonatti J,Lindner KH

    更新日期:2003-03-01 00:00:00

  • Predictors of patients who present to the emergency department with sepsis and progress to septic shock between 4 and 48 hours of emergency department arrival.

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    journal_title:Critical care medicine

    pub_type: 杂志文章


    authors: Capp R,Horton CL,Takhar SS,Ginde AA,Peak DA,Zane R,Marill KA

    更新日期:2015-05-01 00:00:00