Neonatal ECMO
Journal Title: Pediatric Review: International Journal of Pediatric Research - Year 2016, Vol 3, Issue 3
Abstract
ECMO is a technique of providing cardiac & respiratory support to sustain life. Nowadays it is being increasingly used in newborns. Respiratory ECMO is used for severe respiratory distress syndrome, pneumonia & meconium aspiration syndrome. Cardiac ECMO is used after open heart surgery, myocarditis or myopathy. There are two types of ECMO, Veno-Venous (V-V) bypass & Arterio-Venous (A-V) bypass. ECMOcan be used to bridge patients with heart failure as they await heart transplantation & as an adjunct to cardiopulmonary resuscitation. ECMO should be used in reversible diseases only after analysing various factors. Qualifying criteria for ECMO are applied only when the infant has reached maximal ventilatory support. Only babies with gestational Age > 34 weeks, Birth Weight > 2,000 grams, without major coagulopathy, with mechanical ventilation < 14 days & reversible lung disease are eligible for ECMO. Absolute contraindications include Grade 3 or 4 IVH, irreversible brain injury, lethal malformations, non-treatable congenital heart disease & significant coagulopathy. The ECMO circuit consists of a cannula to drain deoxygenated blood from the patient, a pump, an artificial lung to provide oxygenation & ventilation, heat exchanger, a second cannula to return oxygenated blood back to the patient Management during ECMO includes Oxygenation, Inotropic support, Rest Ventilation & Sedation. Complications include Bleeding, Infection, myocardial stun, neurodevelopmental problems, Pneumothorax, pulmonary haemorrhage, bronchial asthma, Sensorineural disabilities,acute tubular necrosis, Feeding difficulty, metabolic derangements, Psychosocial morbidity & Neuromotor deficits .Early initiation of ECMO, monitoring & prompt management of expected complications will improve survivalwithout severe disability.
Authors and Affiliations
Rabindran Rabindran, D Sharad Gedam
Keywords
Related Articles
- EP ID EP223880
- DOI 10.17511
- Views 161
- Downloads 0
Rapidly progressing juvenile scleroderma: A case report
Juvenile Scleroderma encompasses a range of conditions unified by the presence of fibrosis of the skin. Juvenile scleroderma is of two major types: Juvenile localized scleroderma and Juvenile Systemic sclerosis. Juvenile...
Over weight, obesity and metabolic syndrome in a semi urban adolescent population in Uyo, Nigeria
Background: Overweight and Obesity are becoming increasingly common in developing countries with the attendant health risks associated with these conditions including Metabolic syndrome. The aim of this study was to find...
Cord bilirubin as a Predictor of Neonatal Hyper bilirubinemia in healthy term babies
Objectives: To assess the value of cord blood bilirubin in identifying term healthy babies who develop significant hyperbilirubinemia. Methodology: This Prospective cohort study, conducted from May 2016 to September 2016...
Effects of maternal hemoglobin on fetal birth weight
Introduction: Anaemia is one of the main nutritional deficiency disorders affecting a large proportion of the population, not only in developing but also in industrialized countries. The high prevalence of iron and other...
Study of transcranial colour Doppler in the measurement of cerebral edema in birth asphyxia
Background: Perinatal asphyxia is an insult to fetus or newborn due to lack of oxygen /perfusion to various organs. Perinatal asphyxia occurs in 1 to 3 per 1000 live births and is related to gestational age and birth wei...