| The use of extracorporeal life support in pediatric burn patients with respiratory failure. | |
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MedLine Citation:
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PMID: 7595848 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Respiratory failure is the most common cause of death after thermal injury and may be caused by inhalation injury, acute respiratory distress syndrome (ARDS) or pneumonia. ARDS is usually associated with sepsis; however, it may also occur during burn shock, especially in patients that have a delayed or inadequate fluid resuscitation. During the past 24 months, five pediatric burn patients underwent extracorporeal life support (ECLS) for respiratory failure unresponsive to optimal medical management. The mean age of the patients was 26 months (range, 8.5 to 48 months), with a mean burn size of 46% TBSA (> 95% third degree). The etiology of the respiratory failure included severe bronchospasm in a 22-month-old former premature infant with bronchopulmonary dysplasia; three patients with ARDS; and one patient with a severe inhalation injury. All five patients required greater than 56 cm H2O peak pressures and 100% FIO2 at the time of beginning ECLS. The oxygenation index (OI) ranged from 45 to 180. Three (60%) of the patients survived. In the three patients who ultimately survived, significant improvements in pulmonary and hemodynamic parameters occurred within 96 hours of ECLS. The two patients who died showed no improvement and were removed from ECLS at 10 and 11 days; both expired within hours. The patients who expired developed significant hemodynamic instability, coagulopathy, and hemorrhage from their burn wounds. The extent and degree of burn injury did not seem to alter the outcome. Indications for considering ECLS in the pediatric burn patient are unmanageable, life threatening pulmonary insufficiency in patients that undergo a relative short course of pre-ECLS ventilator support.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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M J Goretsky; D G Greenhalgh; G D Warden; F C Ryckman; B W Warner |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of pediatric surgery Volume: 30 ISSN: 0022-3468 ISO Abbreviation: J. Pediatr. Surg. Publication Date: 1995 Apr |
Date Detail:
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Created Date: 1995-08-03 Completed Date: 1995-08-03 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0052631 Medline TA: J Pediatr Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 620-3 Citation Subset: IM |
Affiliation:
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Shriners Burns Institute, Cincinnati Unit, OH, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Burns
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complications*,
therapy Burns, Inhalation / complications*, therapy Child, Preschool Extracorporeal Membrane Oxygenation* Female Humans Infant Male Respiratory Distress Syndrome, Adult / etiology, therapy* Respiratory Insufficiency / etiology, therapy* Retrospective Studies Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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