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ORIGINAL ARTICLE
Year : 2021  |  Volume : 3  |  Issue : 1  |  Page : 18

Application of Awake Extracorporeal Membrane Oxygenation in Pediatric Acute Fulminant Myocarditis: A Single-Center Experience


1 Department of Pediatric Intensive Care Unit, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing; Department of Pediatric Intensive Care Unit, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
2 Department of Pediatric Intensive Care Unit, Luoyang Maternal and Child Health Hospital, Luoyang, China
3 Department of Pediatric Intensive Care Unit, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing, China

Correspondence Address:
Prof. Xiaoyang Hong
Department of Pediatric Intensive Care Unit, The Second School of Clinical Medicine, Southern Medical University, Guangzhou
China
Prof. Zhichun Feng
Department of Pediatric Intensive Care Unit, Faculty of Pediatrics, Chinese PLA General Hospital, Beijing
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jtccm.jtccm_30_21

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Background: Extracorporeal membrane oxygenation (ECMO) has been used for treating myocarditis for years. To extubate and be awake have been proven to be useful in adult patients supported with ECMO, especially for long-term pulmonary support. However, the role of awake ECMO remains still unclear in pediatric patients with acute fulminant myocarditis (AFM). Objectives: The objective is to summarize the application of awake ECMO during the treatment of pediatric AFM. Methods: Seven patients with AFM received ECMO from October 2018 to March 2020 in the Pediatric Intensive Care Unit, Senior Department of Pediatrics, the Seventh Medical Center of PLA General Hospital. During the process, the patients were extubated and supported with awake ECMO. Retrospective analysis of basic characteristics, clinical vital signs, outcomes, and parameters of ECMO was carried out. Results: All the patients received venoarterial mode ECMO during the treatment, and awake ECMO was implemented after the patients were stable. During the period, all the patients were fed with enteral nutrition. The respiratory and circulatory conditions were improved during the awake ECMO. Finally, all the patients successfully weaned from ECMO and survived to discharge from hospital. Conclusion: It is possible for pediatric ECMO-supported patients with AFM to extubation and keep awake. The choice of patients, close monitoring during process, and good coordination are key factors for the successful implementation of awake ECMO.


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