A survey for pain and sedation medications in pediatric patients during extracorporeal membrane oxygenation

DeBerry, Brittany B.; Lynch, James E.; Chernin, Jill M.; Zwischenberger, Joseph B.; Chung, Dai H.
May 2005
Perfusion;May2005, Vol. 20 Issue 3, p139
Academic Journal
Routine administration of large amounts of pain and sedative medication is common to critically ill pediatric patients undergoing extracorporeal membrane oxygenation (ECMO) for cardiopulmonary failure. It has been our experience that pediatric patients are the most difficult age group in which to achieve an ideal pain and sedative control due to the narrow margin of safety. The purpose of this study was to determine the general practice guideline used for pain and anxiolytic pharmacotherapy for pediatric patients at ECMO centers. We sent a survey questionnaire to all ECMO centers in the USA that treat pediatric respiratory failure patients. Of the 46 responding centers (including telephone follow-ups), 37 (80%) centers had an active pediatric ECMO programs for patients with severe respiratory failure. Fentanyl was the most commonly used pain medication and continuous infusion, administered directly to the patient, was preferred. Subjective effectiveness of various pharmacological agents was variable without clear consensus; however, midazolam was considered to be the most effective agent used.


Related Articles

  • Serum butyrylcholinesterase predicts survival following extracorporeal membrane oxygenation after cardiovascular surgery. Distelmaier, Klaus; Winter, Max-Paul; Rützler, Kurt; Heinz, Gottfried; Lang, Irene M.; Maurer, Gerald; Koinig, Herbert; Steinlechner, Barbara; Niessner, Alexander; Goliasch, Georg // Critical Care;2014, Vol. 18 Issue 1, p1 

    Introduction Risk stratification in patients undergoing extracorporeal membrane oxygenation (ECMO) support following cardiovascular surgery remains challenging, since data on specific outcome predictors are limited. Serum butyrylcholinesterase demonstrated a strong inverse association with...

  • Transcatheter closure of a patent arterial duct in a patient on veno-arterial extracorporeal membrane oxygenation. Brown, Kate L.; Shekerdemian, Lara S.; Penny, Daniel J. // Intensive Care Medicine;Apr2002, Vol. 28 Issue 4, p501 

    The presence of a patent arterial duct may complicate the course of the patient on veno-arterial extracorporeal membrane oxygenation (ECMO). While surgical ligation has been traditionally used as a definitive treatment for this problem, transcatheter closure may have advantages. This is the...

  • Prolonged ECMO Support for Virus-Induced Cardiorespiratory Failure Early After Cardiac Surgery. Vida, V. L.; Rubino, M.; Stellin, G. // Pediatric Cardiology;Jan/Feb2006, Vol. 27 Issue 1, p122 

    Extracorporeal membrane oxygenation (ECMO) after cardiac surgery is a rescue for life-threatening respiratory or circulatory failure. Although ECMO support for short periods (<10 days) represents an effective means of respiratory and cardiac support, treatment for longer periods remains...

  • Extracorporeal membrane oxygenation instead of invasive mechanical ventilation in patients with acute respiratory distress syndrome. Hoeper, Marius; Wiesner, Olaf; Hadem, Johannes; Wahl, Oliver; Suhling, Hendrik; Duesberg, Christoph; Sommer, Wiebke; Warnecke, Gregor; Greer, Mark; Boenisch, Olaf; Busch, Markus; Kielstein, Jan; Schneider, Andrea; Haverich, Axel; Welte, Tobias; Kühn, Christian // Intensive Care Medicine;Nov2013, Vol. 39 Issue 11, p2056 

    The article discusses a single-center, uncontrolled pilot trial aimed at assessing the feasibility of veno-venous extracorporeal membrane oxygenation (ECMO) in awake, non-intubated patients with acute respiratory distress syndrome (ARDS). Involved in the study were patients between 18 and 75...

  • Extracorporeal life support in pediatric cardiac dysfunction. Coskun, Kasim O.; Coskun, Sinan T.; Popov, Aron F.; Hinz, Jose; El-Arousy, Mahmoud; Schmitto, Jan D.; Kececioglu, Deniz; Koerfer, Reiner // Journal of Cardiothoracic Surgery;2010, Vol. 5, p112 

    Background: Low cardiac output (LCO) after corrective surgery remains a serious complication in pediatric congenital heart diseases (CHD). In the case of refractory LCO, extra corporeal life support (ECLS) extra corporeal membrane oxygenation (ECMO) or ventricle assist devices (VAD) is the final...

  • Thoracotomy in adults while on ECMO is associated with uncontrollable bleeding. Marasco, Silvana F.; Preovolos, Arthur; Lim, Kiat; Salamonsen, Robert F. // Perfusion;Jan2007, Vol. 22 Issue 1, p23 

    This report details the outcomes of four patients supported by extracorporeal membrane oxygenation (ECMO) who required thoracotomy. All four patients sustained massive bleeding as a result of the operative intervention, which was not controllable in three of the patients who subsequently died....

  • The potential of accurate SVO2 monitoring during venovenous extracorporeal membrane oxygenation: an in vitro model using ultrasound dilution. Walker, Joshua; Primmer, Johanna; Searles, Bruce E.; Darling, Edward M. // Perfusion;Jul2007, Vol. 22 Issue 4, p239 

    Introduction. Some degree of recirculation occurs during venovenous extracorporeal membrane oxygenation (VV ECMO) which, (1) reduces oxygen (O2) delivery, and (2) renders venous line oxygen saturation monitoring unreliable as an index of perfusion adequacy. Ultrasound dilution allows clinicians...

  • Is it possible to predict outcome in pulmonary ECMO? Analysis of pre-operative risk factors. Wagner, K.; Risnes, I.; Abdelnoor, M.; Karlsen, H. M.; Svennevig, J. L. // Perfusion;Mar2008, Vol. 23 Issue 2, p95 

    Serious pulmonary failure may be treated with extracorporeal membrane oxygenation (ECMO) when other treatment has failed. The aim of this study was to analyze preoperative risk factors of early mortality in patients who underwent either veno-arterial (VA) ECMO or venovenous (VV) ECMO for...

  • Argatroban as an alternative to heparin in extracorporeal membrane oxygenation circuits. Young, Guy; Yonekawa, Karyn E.; Nakagawa, Peggy; Nugent, Diane J. // Perfusion;Sep2004, Vol. 19 Issue 5, p283 

    We investigated the anticoagulant effects of argatroban, a direct thrombin inhibitor, versus heparin in extracorporeal membrane oxygenation (ECMO) circuits. Three sham circuits were prepared according to our hospital's standard practice and run for six hours simultaneously. Two circuits were...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics