Extracorporeal membrane oxygenation in the treatment of respiratory failure in pediatric patients with burns

The Journal of Burn Care & Rehabilitation
E J PierreDavid Herndon

Abstract

Extracorporeal membrane oxygenation (ECMO) as a treatment for pulmonary failure from postshock respiratory distress in burned children recently has been shown to salvage patients who were thought to have more than a 90% chance of dying. We describe five burned children in whom severe respiratory failure--not responsive to medical management and maximal ventilatory support--developed, and who underwent ECMO treatment. Three (60%) cases involved flame burns, with significant inhalation injury as diagnosed after a bronchoscopy; mean age was 3 years (2 to 4 years), with a mean total body surface area (TBSA) burn of 32% (15% to 53%), mean third-degree burns of 25% (5% to 53%). Two (40%) cases involved scald burns; mean age was 6 years (7 months to 11 years), with a mean TBSA burn of 56.5% (43% to 70%), mean third-degree burns of 40% (10.5% to 70%). Outcome was poor for those burned children who received ECMO therapy after prolonged ventilatory support for smoke inhalation injury. Children who experience perfusion/reperfusion shock injury to the lungs as a result of delayed resuscitation of scald burns may have an improved chance of survival with short courses of ECMO regardless of the burn size.

Citations

Jun 12, 2009·Der Anaesthesist·M O MaybauerD M Maybauer
Feb 5, 2004·Journal of the American College of Surgeons·Robert L Sheridan, Ronald G Tompkins
Jan 11, 2005·The Journal of Burn Care & Rehabilitation·James T ThompsonThomas Pranikoff
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May 16, 2007·Journal of Burn Care & Research : Official Publication of the American Burn Association·Tina L Palmieri
Aug 27, 2009·Critical Care Medicine·Barbara A Latenser
Nov 29, 2007·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Robert G SvitekJames A Magovern
Oct 16, 2012·Burns : Journal of the International Society for Burn Injuries·Sven AsmussenMarc O Maybauer
May 27, 2008·Pediatric Clinics of North America·Niranjan KissoonDesmond Bohn
Sep 25, 2008·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Marco RicciAnthony L Panos
Mar 10, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Kelly B ThompsonBrian C Bridges
May 3, 2020·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·David J Dries

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