Expanded Application of Extracorporeal Membrane Oxygenation in a Pediatric Surgery Practice

Max Langham, David William Kays, Elizabeth Ann Beierle, Mike K. Chen, Karla Stringfellow, James Lewis Talbert, Samuel D. Smith, J. Alex Haller, Alden H. Harken, Ross M. Ungerleider

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To examine the breadth of application and resulting outcomes in a university-based extracorporeal membrane oxygenation (ECMO) program directed by pediatric surgeons. Summary Background Data: Several randomized control trials have supported the use of ECMO in neonates with respiratory failure. No comparable data exist for older children and young adults who may be afflicted with a variety of uncommon conditions. The indications for ECMO in these patients remain controversial. Methods: Patient data were recorded prospectively and reported to the Extracorporeal Life Support Organization. These data were analyzed by indications and outcomes on all patients treated since the inception of the program. Results: Two hundred sixteen patients were treated with 225 courses of ECMO. Neonates (188 [87%]) outnumbered 28 older patients (aged 6 weeks to 22 years). Overall, 174 patients survived (81%). Sixty-four of 65 (98.5%) neonates with meconium aspiration syndrome survived. ECMO support after heart (3), lung (2), heart-lung (1), and liver (1) transplant yielded a 57% survival to discharge. ECMO also resulted in survival of patients with uncommon conditions, including severe asthma (1), hydrocarbon aspiration (1/2), congestive heart failure due to a cerebral arteriovenous malformation (1), tracheal occlusion incurred during endoscopic stent manipulation (2), meningitis (1), and viral pneumonia (3/5). Conclusions: ECMO can potentially eliminate mortality for meconium aspiration syndrome. Survival for other causes of respiratory failure in neonates and older children, while not as dramatic, still surpasses that anticipated with conventional therapy. Moreover, survival of transplant patients has been comparable to that achieved in other children.

Original languageEnglish (US)
Pages (from-to)766-774
Number of pages9
JournalAnnals of Surgery
Volume237
Issue number6
DOIs
StatePublished - Jun 1 2003
Externally publishedYes

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Extracorporeal Membrane Oxygenation
Pediatrics
Meconium Aspiration Syndrome
Newborn Infant
Respiratory Insufficiency
Survival
Viral Pneumonia
Intracranial Arteriovenous Malformations
Transplants
Lung
Hydrocarbons
Meningitis
Stents
Young Adult
Asthma
Heart Failure
Organizations
Mortality
Liver

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Langham, M., Kays, D. W., Beierle, E. A., Chen, M. K., Stringfellow, K., Talbert, J. L., ... Ungerleider, R. M. (2003). Expanded Application of Extracorporeal Membrane Oxygenation in a Pediatric Surgery Practice. Annals of Surgery, 237(6), 766-774. https://doi.org/10.1097/00000658-200306000-00004

Expanded Application of Extracorporeal Membrane Oxygenation in a Pediatric Surgery Practice. / Langham, Max; Kays, David William; Beierle, Elizabeth Ann; Chen, Mike K.; Stringfellow, Karla; Talbert, James Lewis; Smith, Samuel D.; Haller, J. Alex; Harken, Alden H.; Ungerleider, Ross M.

In: Annals of Surgery, Vol. 237, No. 6, 01.06.2003, p. 766-774.

Research output: Contribution to journalArticle

Langham, M, Kays, DW, Beierle, EA, Chen, MK, Stringfellow, K, Talbert, JL, Smith, SD, Haller, JA, Harken, AH & Ungerleider, RM 2003, 'Expanded Application of Extracorporeal Membrane Oxygenation in a Pediatric Surgery Practice', Annals of Surgery, vol. 237, no. 6, pp. 766-774. https://doi.org/10.1097/00000658-200306000-00004
Langham, Max ; Kays, David William ; Beierle, Elizabeth Ann ; Chen, Mike K. ; Stringfellow, Karla ; Talbert, James Lewis ; Smith, Samuel D. ; Haller, J. Alex ; Harken, Alden H. ; Ungerleider, Ross M. / Expanded Application of Extracorporeal Membrane Oxygenation in a Pediatric Surgery Practice. In: Annals of Surgery. 2003 ; Vol. 237, No. 6. pp. 766-774.
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AU - Talbert, James Lewis

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