Author:
Lin Ru,Wang Wei,Wang Xu,Xu Zhuo-Ming,Liu Jin-Ping,Zhou Cheng-Bin,Hong Xiao-Yang,Mo Xu-Ming,Shi Shan-Shan,Ye Li-Fen,Shu Qiang
Abstract
Abstract
Background
Congenital heart disease (CHD) is one of the main supportive diseases of extracorporeal membrane oxygenation in children. The management of extracorporeal membrane oxygenation (ECMO) for pediatric CHD faces more severe challenges due to the complex anatomical structure of the heart, special pathophysiology, perioperative complications and various concomitant malformations. The survival rate of ECMO for CHD was significantly lower than other classifications of diseases according to the Extracorporeal Life Support Organization database. This expert consensus aims to improve the survival rate and reduce the morbidity of this patient population by standardizing the clinical strategy.
Methods
The editing group of this consensus gathered 11 well-known experts in pediatric cardiac surgery and ECMO field in China to develop clinical recommendations formulated on the basis of existing evidences and expert opinions.
Results
The primary concern of ECMO management in the perioperative period of CHD are patient selection, cannulation strategy, pump flow/ventilator parameters/vasoactive drug dosage setting, anticoagulation management, residual lesion screening, fluid and wound management and weaning or transition strategy. Prevention and treatment of complications of bleeding, thromboembolism and brain injury are emphatically discussed here. Special conditions of ECMO management related to the cardiovascular anatomy, haemodynamics and the surgical procedures of common complex CHD should be considered.
Conclusions
The consensus could provide a reference for patient selection, management and risk identification of perioperative ECMO in children with CHD.
Funder
Fundamental Research Funds for Central Universities of the Central South University
Key Technology Research and Development Program of Shandong
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
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