RESUMO
Patients on circulatory support can be the source of multiple challenges including optimizing the circuit for specific congenital heart lesions, troubleshooting circuit failures, transporting patients on the circuit, anticoagulation and bleeding, transitioning to more mobile ventricular assist device, listing for thoracic organ transplantation, weaning from the circuit, and educating the patient and family about mechanical support. These challenges ideally require a specialized multidisciplinary team, which includes anesthesiologists, child life specialists, extracorporeal membrane oxygenation (ECMO) specialists, intensivists, nurses, nutritionists, perfusionists, pharmacists, respiratory therapists, social workers, and surgeons.
RESUMO
Over the past 6 years at Penn State Hershey, we have established the pediatric cardiovascular research center with a multidisciplinary research team with the goal to improve the outcomes for children undergoing cardiac surgery with cardiopulmonary bypass (CPB) and extracorporeal life support (ECLS). Due to the variety of commercially available pediatric CPB and ECLS devices, both in vitro and in vivo translational research have been conducted to achieve the optimal choice for our patients. By now, every component being used in our clinical settings in Penn State Hershey has been selected based on the results of our translational research. The objective of this review is to summarize our translational research in Penn State Hershey Pediatric Cardiovascular Research Center and to share the latest results with all the interested centers.
RESUMO
The following is a description of the training offered to extracorporeal life support (ECLS)-trained staff at the Penn State Hershey Children's Hospital. Changes with the ECLS circuit prompted the need for an initiative to train staff in the care of patients requiring ECLS support. In addition to didactic material, we incorporated a "hands-on" approach in designing the education. During the didactic portion, the circuit was demonstrated as a wet lab. The final step offered a voluntary visit to the animal research facility utilizing clinical case scenarios which allowed participants to articulate and demonstrate proper circuit management.The effort throughout this process was to build a competent ECLS team which will ultimately provide our patients with the greatest chance for a full recovery.
