The Evolution of Extracorporeal Membrane Oxygenation Circuitry and Impact on Clinical Outcomes in Children: A Systematic Review

被引:11
作者
Cai, Tengyi [1 ,2 ]
Swaney, Ella [1 ,2 ]
van den Helm, Suelyn [1 ,2 ]
Brown, Georgia [3 ]
MacLaren, Graeme [1 ,2 ,3 ,4 ]
Horton, Stephen [1 ,2 ,5 ]
Monagle, Paul [1 ,2 ,6 ,7 ]
Ignjatovic, Vera [1 ,2 ,8 ]
机构
[1] Murdoch Childrens Res Inst, Haematol, Melbourne, Australia
[2] Univ Melbourne, Dept Paediat, Melbourne, Australia
[3] Royal Childrens Hosp, Paediat ICU, Melbourne, Australia
[4] Natl Univ Singapore Hosp, Cardiothorac ICU, Singapore, Singapore
[5] Royal Childrens Hosp, Dept Cardiac Surg, Melbourne, Australia
[6] Royal Childrens Hosp, Dept Clin Haematol, Melbourne, Australia
[7] Sydney Childrens Hosp, Kids Canc Ctr, Randwick, Australia
[8] Murdoch Childrens Res Inst, Haematol, 50 Flemington Rd, Melbourne, Vic 3052, Australia
关键词
ECMO; children; circuit; pump; oxygenator; LIFE-SUPPORT; PENTENE OXYGENATORS; RESPIRATORY-FAILURE; CENTRIFUGAL; PUMPS;
D O I
10.1097/MAT.0000000000001785
中图分类号
R318 [生物医学工程];
学科分类号
0831 ;
摘要
This systematic review summarizes the major developments in extracorporeal membrane oxygenation (ECMO) circuitry in pediatrics over the past 20 years and demonstrates the impacts of those developments on clinical outcomes. This systematic review followed structured Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 1987 studies were retrieved, of which 82 were included in the final analysis. Over the past 20 years, ECMO pumps have shifted from roller pumps to centrifugal pumps. Silicone and polypropylene hollow fiber membrane oxygenators were initially used but have been replaced by polymethylpentene hollow fiber membrane oxygenators, with other ECMO components poorly reported. Considerable variability in mortality was found across studies and there was no statistical difference in mortality rates across different periods. The duration of ECMO and other outcome measures were inconsistently reported across studies. This systematic review demonstrated technological developments in pumps and oxygenators over the last two decades, although patient mortality rates remained unchanged. This could be because of ECMO support applied to patients in more critical conditions over the years. We also highlighted the limitations of methodology information disclosure and outcome measures in current ECMO studies, showing the need of reporting standardization for future ECMO studies.
引用
收藏
页码:247 / 253
页数:7
相关论文
共 27 条
[1]   Extracorporeal membrane oxygenation in burn and smoke inhalation injury [J].
Asmussen, Sven ;
Maybauer, Dirk M. ;
Fraser, John F. ;
Jennings, Kristofer ;
George, Shane ;
Keiralla, Amar ;
Maybauer, Marc O. .
BURNS, 2013, 39 (03) :429-435
[2]   Pediatric Extracorporeal Life Support Organization Registry International Report 2016 [J].
Barbaro, Ryan P. ;
Paden, Matthew L. ;
Guner, Yigit S. ;
Raman, Lakshmi ;
Ryerson, Lindsay M. ;
Alexander, Peta ;
Nasr, Viviane G. ;
Bembea, Melania M. ;
Rycus, Peter T. ;
Thiagarajan, Ravi R. .
ASAIO JOURNAL, 2017, 63 (04) :456-463
[3]   Association of Hospital-Level Volume of Extracorporeal Membrane Oxygenation Cases and Mortality Analysis of the Extracorporeal Life Support Organization Registry [J].
Barbaro, Ryan P. ;
Odetola, Folafoluwa O. ;
Kidwell, Kelley M. ;
Paden, Matthew L. ;
Bartlett, Robert H. ;
Davis, Matthew M. ;
Annich, Gail M. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2015, 191 (08) :894-901
[4]   Pediatric ECMO Outcomes: Comparison of Centrifugal Versus Roller Blood Pumps Using Propensity Score Matching [J].
Barrett, Cindy S. ;
Jaggers, James J. ;
Cook, E. Francis ;
Graham, Dionne A. ;
Yarlagadda, Vasmi V. ;
Teele, Sarah A. ;
Almond, Christopher S. ;
Bratton, Susan L. ;
Seeger, John D. ;
Dalton, Heidi J. ;
Rycus, Peter T. ;
Laussen, Peter C. ;
Thiagarajan, Ravi R. .
ASAIO JOURNAL, 2013, 59 (02) :145-151
[5]   Outcomes of Neonates Undergoing Extracorporeal Membrane Oxygenation Support Using Centrifugal Versus Roller Blood Pumps [J].
Barrett, Cindy S. ;
Jaggers, James J. ;
Cook, E. Francis ;
Graham, Dionne A. ;
Rajagopal, Satish K. ;
Almond, Christopher S. ;
Seeger, John D. ;
Rycus, Peter T. ;
Thiagarajan, Ravi R. .
ANNALS OF THORACIC SURGERY, 2012, 94 (05) :1635-1642
[6]   Technical Advances in the Field of ECMO [J].
Betit, Peter .
RESPIRATORY CARE, 2018, 63 (09) :1162-1173
[7]  
Brogan TV., 2017, Extracorporeal Life Support: The ELSO Red Book, V5
[8]   Venoarterial extracorporeal membrane oxygenation: A systematic review of selection criteria, outcome measures and definitions of complications [J].
Burrell, Aidan J. C. ;
Bennett, Victoria ;
Serra, Alexis L. ;
Pellegrino, Vincent A. ;
Romero, Lorena ;
Fan, Eddy ;
Brodie, Daniel ;
Cooper, D. James ;
Kaye, David M. ;
Fraser, John F. ;
Hodgson, Carol L. .
JOURNAL OF CRITICAL CARE, 2019, 53 :32-37
[9]  
Extracorporeal Life Support Organization, 2020, ECLS REG REP, P1
[10]   First serial in vivo results of mechanical circulatory support in children with a new diagonal pump [J].
Fleck, Thilo ;
Benk, Christoph ;
Klemm, Rolf ;
Kroll, Johannes ;
Siepe, Matthias ;
Grohmann, Jochen ;
Hoehn, Rene ;
Humburger, Frank ;
Beyersdorf, Friedhelm ;
Stiller, Brigitte .
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY, 2013, 44 (05) :828-835