Listener Feedback Survey

Learning Objectives:After listening to this episode, learners should be able to:

  1. Explain the key milestones that a patient needs to reach before they are a candidate for extubation while on VV-ECMO.
  2. Contrast the mobilization best practices for infants vs school-aged children on VV-ECMO.
  3. Describe the long-term neurologic effects of a VV-ECMO run, both in infancy and as a school-aged child.

About our guests:

Jenna Miller, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. She completed her medical school and residency in Kansas City before moving to Texas Children’s for critical care fellowship. She is the director of the pediatric ECMO program and the pediatric critical care medicine fellowship at Children’s Mercy Kansas City. Her professional and research interests include trimethoprim-sulfamethoxazole ARDS, ECMO and medical education.

Dr John Daniel, MD is an Associate Professor of Pediatrics at the University of Missouri-Kansas City School of Medicine. He completed his pediatric residency at the University of South Carolina and his neonatology fellowship at the University of Kentucky. He now is a practicing Neonatal Cardiac Intensivist and the director of the neonatal ECMO program at Children’s Mercy Kansas City.

ECMO Patient Stories from Children’s Mercy Kansas City:

https://www.cnn.com/2018/03/21/health/teen-walks-on-life-support-exclusive-profile

https://www.thedailybeast.com/trevor-hensley-endured-73-days-of-ecmo-to-survive-covid

https://news.childrensmercy.org/mcpherson-news-ledger-mcpherson-boy-home-following-100-day-hospital-stay/

References:

  1. Maclare, Graeme, et al. Extracorporeal Life Support: The ELSO Red Book. 6th Edition.
  2. Pelosi, er al. Close down the lungs + keep them resting to minimize ventilator induced lung injury.
  3. Maharaj et al, Right Ventricular Dysfunction is Associated with Increased Mortality in Patients Requiring Venovenous Extracorporeal Membrane Oxygenation for Coronavirus Disease 2019
  4. Nirmal S Sharma et al. Flexible Bronchoscopy Is Safe and Effective in Adult Subjects Supported With Extracorporeal Membrane Oxygenation.
  5. Rosner EA et al. Flexible Bronchoscopy in Pediatric Venovenous Extracorporeal Membrane Oxygenation.
  6. Gurnani et al. Outcomes of Extubated COVID and Non-COVID Patients Receiving Awake Venovenous Extracorporeal Membrane Oxygenation,
  7. Kohne et al. Tracheostomy Practices and Outcomes in Children During Respiratory Extracorporeal Membrane Oxygenation
  8. Palen P et al. tracheostomy and long-term mechanical ventilation in children after veno-venous extracorporeal membrane oxygenation.
  9. LaRosa JM, Nelliot A, Zaidi M, Vaidya D, Awojoodu R, Kudchadkar SR. Mobilization Safety of Critically Ill Children. Pediatrics.

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