Pediatric ECMO after drowning: Neuroprotective strategies. (September 2018)

• Record Type: Journal Article
• Authors: Nelson, Jennifer S.; Longani, Neha; Sigurdardottir, Laufey Y.; Maul, Timothy M.; Wearden, Peter D.; Chrysostomou, Constantinos
• Is Part Of: Progress in pediatric cardiology. Volume 50(2018)
• Page Start: 34
• Page End: 38
• Publication Date: 2018-09
• Subjects: ECMO -- Hypothermia -- Neuroprotection -- Dexmedetomidine -- Erythropoietin -- Drowning; Pediatric cardiology -- Periodicals; Cardiovascular Diseases -- Periodicals; Infant; Child; Cardiologie pédiatrique -- Périodiques; 618.9212005
• DOI: 10.1016/j.ppedcard.2018.05.004
• Languages: English
• ISSNs: 1058-9813

Abstract

Abstract: There are no established neuroprotective guidelines during pediatric extracorporeal membrane oxygenation (ECMO) after cardiac arrest. We report a case of unknown duration, out-of-hospital cardiac arrest after drowning in a toddler. The patient experienced severe cardiopulmonary failure shortly after return of spontaneous circulation and required veno-arterial ECMO. Clinical outcome was excellent. This report outlines a neuroprotective strategy using high-dose erythropoietin, dexmedetomidine, and therapeutic hypothermia that was implemented during ECMO. Risk factors related to pediatric drowning with cardiac arrest are also discussed. Highlights: A comatose drowned child with hypothermia survived with ECMO resuscitation Therapeutic hypothermia with slow rewarming was utilized following out of hospital cardiac arrest During ECMO, therapeutic hypothermia, dexmedetomidine, and erythropoietin may offer neuroprotection after drowning