Abstract
The use of extracorporeal membrane oxygenation (ECMO) in the pediatric age has increased considerably in the last decade, as has the complexity of cases and the variety of indications outside of the neonatal age. However, no randomized controlled trials have been attempted to date to test ECMO as an intervention in non-neonatal pediatric patients with critical illness. In this review, we provide a brief overview of the history of clinical research in pediatric ECMO and discuss methodological challenges including heterogeneity of ages and diagnoses in the pediatric ECMO population, rapid advances in technology and clinical practice related to ECMO, feasibility of enrolling critically ill children on ECMO in clinical research studies, and variability in ECMO management across institutions and countries. Lastly, we discuss opportunities and existing infrastructure for future multicenter, multi-network research collaborations for pediatric ECMO studies.
Highlights
The epidemiology of pediatric extracorporeal membrane oxygenation (ECMO) support in infants and children has undergone dramatic changes since the first ECMO case reports in the 1970’s [1, 2]
Despite what has become a routine technology in the Pediatric Intensive Care Units (PICU), most clinical research studies conducted in pediatric ECMO have been observational in nature, with generally small sample sizes and methodological challenges stemming from the heterogeneity of patient ages, diagnoses, and equipment used, and variability in practice among ECMO providers and across institutions and countries
We provide a brief overview of the history of clinical research in pediatric ECMO, discuss methodological challenges, and discuss opportunities for future multicenter, multi-network research collaborations for pediatric ECMO studies
Summary
The epidemiology of pediatric extracorporeal membrane oxygenation (ECMO) support in infants and children has undergone dramatic changes since the first ECMO case reports in the 1970’s [1, 2]. ECMO technology was used overwhelmingly in neonates in the first decades of its development, primarily for indications such as meconium aspiration syndrome, persistent pulmonary hypertension of the newborn, and respiratory distress syndrome. More than 63,000 newborns, infants and children
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