Vascular Reconstruction After Cannulation for Support With Extracorporeal Membrane Oxygenation: Literature Review of Data in the Pediatric Population.
Pediatr Crit Care Med
; 24(12): 1072-1083, 2023 Dec 01.
Article
em En
| MEDLINE
| ID: mdl-37796088
ABSTRACT
OBJECTIVES:
Extracorporeal membrane oxygenation (ECMO) is an invaluable life-support resource in the treatment of critically ill children. Traditionally, neck vascular cannulation requires ligation of the carotid artery and jugular vein. In this literature review, we identify rates of postoperative vessel patency, complications, and neurologic outcomes after vascular reconstruction following decannulation. DATA SOURCES Embase, PubMed, and Cochrane Review. STUDY SELECTION No publication date limits. Inclusion criteria comprised of studies addressing repair of the carotid artery and jugular vein after ECMO decannulation and outcomes from this procedure. DATA EXTRACTION Authors identified publications on vascular reconstruction after ECMO decannulation, including possible technical considerations, complications, and outcomes. DATASYNTHESIS:
We identified 18 articles 13 studies were limited to the neonatal population. The largest series included 51 patients after vascular reconstruction. The rate of postoperative arterial occlusion ranged from 11.8% to 17.8%, and overall patency rate postoperatively was 78.6%. No major thromboembolic events were reported. One study demonstrated an increase in neuroimaging abnormalities for patients undergoing ligation compared with vascular reconstruction. No studies demonstrated differences in functional neurodevelopmental testing.CONCLUSIONS:
Vascular reconstruction after ECMO decannulation has been reported since 1990. Although reconstruction does not appear to carry significant short-term morbidity, there are no large prospective studies or randomized controlled trials demonstrating its efficacy in improving neurologic outcomes in ECMO patients. There is also a paucity of data regarding outcomes in older children or long-term ramifications of vascular reconstruction.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Oxigenação por Membrana Extracorpórea
Tipo de estudo:
Clinical_trials
/
Observational_studies
/
Prognostic_studies
Limite:
Child
/
Humans
/
Newborn
Idioma:
En
Revista:
Pediatr Crit Care Med
Assunto da revista:
PEDIATRIA
/
TERAPIA INTENSIVA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Azerbaidjão