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.

Background: We aimed to establish a modified cecal ligation and puncture (CLP) rat model with omentectomy for simulating moderate-to-severe septic kidney injury (AKI). Subjects and Methods: Rats were randomly divided into four groups subjected to: Traditional CLP (n = 40); the modified CLP procedure (n = 40); sham surgery (abdominal incision only) (n = 6); and abdominal incision and omentectomy only (n = 6). We evaluated the severity of renal injury according to serum creatinine levels at 0, 24, and 48 h postoperatively and cystatin C and neutrophil gelatinase-associated lipocalin (NGAL) levels at 12 h postoperatively, graded the severity of sepsis, monitored the degree of peritonitis, and examined animal survival. Results: Compared with the traditional CLP group, the modified CLP group developed more severe sepsis at postoperative 48 h, had more severe renal pathology, and developed more severe AKI with high homogeneity. Most rats in the traditional CLP group exhibited complete wrapping of the puncture site by omentum with limited peritonitis, while partial wrapping with pus spreading was observed in some. All rats in the modified CLP group developed puncture site necrosis, with pus spreading without formation of an encapsulated abscess, and a consistent degree of peritonitis. The 7-day survival rates in the traditional and modified CLP groups were 65.0% and 50.0%, respectively. Conclusion: The traditional CLP approach was associated with an even distribution of different AKI severities among treated animals, whereas the modified CLP approach established a consistently more severe rat model of septic AKI, constituting an important advance for optimizing septic AKI animal models.