Title
Author
DOI
Article Type
Special Issue
Volume
Issue
Extracorporeal membrane oxygenation for refractory septic shock in children
1Department of Intensive Care Unit of Hunan Children’s Hospital, 410007 Changsha, Hunan, China
DOI: 10.22514/sv.2024.051 Vol.20,Issue 5,May 2024 pp.1-7
Submitted: 13 September 2023 Accepted: 09 November 2023
Published: 08 May 2024
*Corresponding Author(s): Zhenghui Xiao E-mail: xiaozh@hnetyy.net
† These authors contributed equally.
Children are susceptible to developing sepsis. Among its complications, septic shock is the most severe. Refractory septic shock (RSS) is defined as septic shock that is unresponsive to standard resuscitation. As the most severe complication of sepsis in children, refractory septic shock (RSS) is characterized by its rapid development and high mortality rate. In accordance with relevant guidelines and consensus, extracorporeal membrane oxygenation (ECMO) is recommended as a salvage therapy for the treatment of RSS in children. However, various controversies and difficulties still exists when ECMO is used to treat children with RSS. Thus, this review summarizes the current status, difficulties, and explorations of applying ECMO to the treatment of RSS in children.
ECMO; RSS; Children
Yufan Yang,Xiangni Wang,Jiaotian Huang,Xiulan Lu,Zhenghui Xiao. Extracorporeal membrane oxygenation for refractory septic shock in children. Signa Vitae. 2024. 20(5);1-7.
[1] Morin L, Ray S, Wilson C, Remy S, Benissa MR, Jansen NJG, et al. Refractory septic shock in children: a European society of paediatric and neonatal intensive care definition. Intensive Care Medicine. 2016; 42: 1948–1957.
[2] Deep A, Goonasekera CDA, Wang Y, Brierley J. Evolution of haemodynamics and outcome of fluid-refractory septic shock in children. Intensive Care Medicine. 2013; 39: 1602–1609.
[3] McCune S, Short BL, Miller MK, Lotze A, Anderson KD. Extracorporeal membrane oxygenation therapy in neonates with septic shock. Journal of Pediatric Surgery. 1990; 25: 479–482.
[4] Beca J, Butt W. Extracorporeal membrane oxygenation for refractory septic shock in children. Pediatrics. 1994; 93: 726–729.
[5] Davis AL, Carcillo JA, Aneja RK, Deymann AJ, Lin JC, Nguyen TC, et al. American college of critical care medicine clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock. Critical Care Medicine. 2017; 45: 1061–1093.
[6] Brierley J, Carcillo JA, Choong K, Cornell T, DeCaen A, Deymann A, et al. Clinical practice parameters for hemodynamic support of pediatric and neonatal septic shock: 2007 update from the American college of critical care medicine. Critical Care Medicine. 2009; 37: 666–688.
[7] Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, et al; Surviving Sepsis Campaign Guidelines Committee including The Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock, 2012. Intensive Care Medicine. 2013; 39: 165–228.
[8] MacLaren G, Butt W, Best D, Donath S, Taylor A. Extracorporeal membrane oxygenation for refractory septic shock in children: one institutionʼs experience. Pediatric Critical Care Medicine. 2007; 8: 447–451.
[9] MacLaren G, Butt W, Best D, Donath S. Central extracorporeal membrane oxygenation for refractory pediatric septic shock. Pediatric Critical Care Medicine. 2011; 12: 133–136.
[10] Rambaud J, Guellec I, Guilbert J, Renolleau S. Venoarterial extracorporeal membrane oxygenation support for neonatal and pediatric refractory septic shock. Indian Journal of Critical Care Medicine. 2015; 19: 600–605.
[11] Solé A, Jordan I, Bobillo S, Moreno J, Balaguer M, Hernández-Platero L, et al. Venoarterial extracorporeal membrane oxygenation support for neonatal and pediatric refractory septic shock: more than 15 years of learning. European Journal of Pediatrics. 2018; 177: 1191–1200.
[12] van Leeuwen Bichara GC, Furlanetto B, Gondim Teixeira L, Di Nardo M. Is peripheral venovenous-arterial ECMO a feasible alternative to central cannulation for pediatric refractory septic shock? Intensive Care Medicine. 2019; 45: 1658–1660.
[13] Ruth A, Vogel AM, Adachi I, Shekerdemian LS, Bastero P, Thomas JA. Central venoarterial extracorporeal life support in pediatric refractory septic shock: a single center experience. Perfusion. 2022; 37: 385–393.
[14] Workman JK, Bailly DK, Reeder RW, Dalton HJ, Berg RA, Shanley TP, et al. Risk factors for mortality in refractory pediatric septic shock supported with extracorporeal life support. ASAIO Journal. 2020; 66: 1152–1160.
[15] Napp LC, Kühn C, Hoeper MM, Vogel-Claussen J, Haverich A, Schäfer A, et al. Cannulation strategies for percutaneous extracorporeal membrane oxygenation in adults. Clinical Research in Cardiology. 2016; 105: 283–296.
[16] Warnock B, Lafferty GM, Farhat A, Colgate C, Dhar A, Gray B. Peripheral veno-arterial-extracorporeal membrane oxygenation for refractory septic shock in children: a multicenter review. To be published in Journal of Intensive Care Medicine. 2023. [Preprint].
[17] Melnikov G, Grabowski S, Broman LM. Extracorporeal membrane oxygenation for septic shock in children. ASAIO Journal. 2022; 68: 262–267.
[18] Chang T, Wu E, Lu C, Huang S, Yang T, Wang C, et al. Pathogens and outcomes in pediatric septic shock patients supported by extracorporeal membrane oxygenation. Journal of Microbiology, Immunology and Infection. 2018; 51: 385–391.
[19] Pedro TDCS, Morcillo AM, Baracat ECE. Etiology and prognostic factors of sepsis among children and adolescents admitted to the intensive care unit. Revista Brasileira De Terapia Intensiva. 2015; 27: 240–246.
[20] Guo J, Luo Y, Wu Y, Lai W, Mu X. Clinical characteristic and pathogen spectrum of neonatal sepsis in Guangzhou city from June 2011 to June 2017. Medical Science Monitor. 2019; 25: 2296–2304.
[21] Norfolk SG, Hollingsworth CL, Wolfe CR, Govert JA, Que LG, Cheifetz IM, et al. Rescue therapy in adult and pediatric patients with pH1N1 influenza infection: a tertiary center intensive care unit experience from April to October 2009. Critical Care Medicine. 2010; 38: 2103–2107.
[22] Prodhan P, Bhutta AT, Gossett JM, Stroud MH, Rycus PT, Bratton SL, et al. Extracorporeal membrane oxygenation support among children with adenovirus infection. ASAIO Journal. 2014; 60: 49–56.
[23] Permpikul C, Sringam P, Tongyoo S. Therapeutic goal achievements during severe sepsis and septic shock resuscitation and their association with patients’ outcomes. Journal of the Medical Association of Thailand. 2014; 97: S176–183.
[24] Scolari F L, Schneider D, Fogazzi D V, Gus M, Rover M M, Bonatto M G, et al. Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study. BMC Cardiovascular Disorders. 2020; 20: 496.
[25] Masha L, Peerbhai S, Boone D, Shobayo F, Ghotra A, Akkanti B, et al. Yellow means caution: correlations between liver injury and mortality with the use of VA-ECMO. ASAIO Journal. 2019; 65: 812–818.
[26] Yang Y, Xiao Z, Huang J, Gong L, Lu X. Role of extracorporeal membrane oxygenation in adults and children with refractory septic shock: a systematic review and meta-analysis. Frontiers in Pediatrics. 2021; 9: 791781.
[27] Cheng A, Sun H, Tsai M, Ko W, Tsai P, Hu F, et al. Predictors of survival in adults undergoing extracorporeal membrane oxygenation with severe infections. The Journal of Thoracic and Cardiovascular Surgery. 2016; 152: 1526–1536.e1.
[28] Oberender F, Ganeshalingham A, Fortenberry JD, Hobson MJ, Houmes RJ, Morris KP, et al. Venoarterial extracorporeal membrane oxygenation versus conventional therapy in severe pediatric septic shock. Pediatric Critical Care Medicine. 2018; 19: 965–972.
[29] Le Gall A, Follin A, Cholley B, Mantz J, Aissaoui N, Pirracchio R. Veno-arterial-ECMO in the intensive care unit: from technical aspects to clinical practice. Anaesthesia Critical Care & Pain Medicine. 2018; 37: 259–268.
[30] Reed RC, Rutledge JC. Laboratory and clinical predictors of thrombosis and hemorrhage in 29 pediatric extracorporeal membrane oxygenation nonsurvivors. Pediatric and Developmental Pathology. 2010; 13: 385–392.
[31] Fletcher-Sandersjöö A, Thelin E P, Bartek J, Broman M, Sallisalmi M, Elmi-Terander A, et al. Incidence, outcome, and predictors of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation: a systematic and narrative review. Frontiers in Neurology. 2018; 9: 548.
[32] Fletcher-Sandersjöö A, Thelin E P, Bartek J, Elmi-Terander A, Broman M, Bellander B-M. Management of intracranial hemorrhage in adult patients on extracorporeal membrane oxygenation (ECMO): an observational cohort study. PLOS ONE. 2017; 12: e0190365.
[33] Fang ZA, Navaei AH, Hensch L, Hui SR, Teruya J. Hemostatic management of extracorporeal circuits including cardiopulmonary bypass and extracorporeal membrane oxygenation. Seminars in Thrombosis and Hemostasis. 2020; 46: 62–72.
[34] Ostermann M, Connor M, Kashani K. Continuous renal replacement therapy during extracorporeal membrane oxygenation: why, when and how? Current Opinion in Critical Care. 2018; 24: 493–503.
[35] Paden ML, Warshaw BL, Heard ML, Fortenberry JD. Recovery of renal function and survival after continuous renal replacement therapy during extracorporeal membrane oxygenation. Pediatric Critical Care Medicine. 2011; 12: 153–158.
[36] Dado D, Ainsworth C, Thomas S, Huang B, Piper L, Sams V, et al. Outcomes among patients treated with renal replacement therapy during extracorporeal membrane oxygenation: a single-center retrospective study. Blood Purification. 2020; 49: 341–347.
[37] Chen S-W, Lu Y-A, Lee C-C, Chou A-H, Wu V C-C, Chang S-W, et al. Long-term outcomes after extracorporeal membrane oxygenation in patients with dialysis-requiring acute kidney injury: a cohort study. PLOS ONE. 2019; 14: e0212352.
[38] Kuo G, Chen S, Fan P, Wu VC, Chou A, Lee C, et al. Analysis of survival after initiation of continuous renal replacement therapy in patients with extracorporeal membrane oxygenation. BMC Nephrology. 2019; 20: 318.
[39] Lee K W, Cho C W, Lee N, Choi G-S, Cho Y H, Kim J M, et al. Extracorporeal membrane oxygenation support for refractory septic shock in liver transplantation recipients. Annals of Surgical Treatment and Research. 2017; 93: 152–158.
[40] Ziogas IA, Johnson WR, Matsuoka LK, Rauf MA, Thurm C, Hall M, et al. Extracorporeal membrane oxygenation in pediatric liver transplantation: a multicenter linked database analysis and systematic review of the literature. Transplantation. 2021; 105: 1539–1547.
[41] Abe M, Ide K, Nishimura N, Nakagawa S, Fukuda A, Sakamoto S, et al. Successful venoarterial extracorporeal membrane oxygenation for postoperative septic shock in a child with liver transplantation: a case report. Pediatric Transplantation. 2017; 21: e13063.
[42] Scott J P, Hong J C, Thompson N E, Woods R K, Hoffman G M. Central ECMO for circulatory failure following pediatric liver transplantation. Perfusion. 2018; 33: 704–706.
[43] Zeng LA, Hwang NC. Vasoplegia: more Magic Bullets? Journal of Cardiothoracic and Vascular Anesthesia. 2019; 33: 1308–1309.
[44] Jaiswal A, Silver E. Extended continuous infusion of methylene blue for refractory septic shock. Indian Journal of Critical Care Medicine. 2020; 24: 206–207.
[45] Cherian A, Senthilnathan M, Balachander H, Maroju N. Role of methylene blue in the maintenance of postinduction hemodynamic status in patients with perforation peritonitis: a pilot study. Anesthesia: Essays and Researches. 2017; 11: 665.
[46] Saha BK, Burns SL. The story of nitric oxide, sepsis and methylene blue: a comprehensive pathophysiologic review. The American Journal of the Medical Sciences. 2020; 360: 329–337.
Top