RT Book, Section
A1 Rozenfeld, Ranna A.
SR Print(0)
ID 1152488145
T1 Mechanical Circulatory Support
T2 The PICU Handbook
YR 2018
FD 2018
PB McGraw-Hill Education
PP New York, NY
SN 9781259834370
LK accesspediatrics.mhmedical.com/content.aspx?aid=1152488145
RD 2022/08/10
AB Children  with  severe  cardiac  or  respiratory  failure  that  is  refractory  to  medical  management  may  require  mechanical  cardiorespiratory  support.  Transient  respiratory  and/or  circulatory  support  can  be  accomplished  using  extracorporeal  membrane  oxygenation  (ECMO)  (see  Chapter  25),  but  prolonged  use  of  ECMO  is  associated  with  increased  morbidity  and  mortality  due  to  the  inflammation,  thromboembolic  complications,  and  issues  with  durability  related  to  the  oxygenator.  Longer-term  circulatory  support  without  an  oxygenator  can  be  accomplished  using  a  ventricular  assist  device  (VAD)  in  patients  with  adequate  pulmonary  status.  Currently,  only  the  Berlin  EXCOR  is  approved  by  the  Food  and  Drug  Administration  (FDA)  for  pediatric  use,  but  a  number  of  adult  VADs  are  being  used  in  older  children  and  adolescents.