Operational Innovation in the Provision of Pediatric Extracorporeal Membrane Oxygenation for Multisystem Inflammatory Syndrome in Children.

Autor: Naber CE; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Fernandes ND; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Lahoud-Rahme M; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Doucette D; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Goldstein AM; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Yager PH; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Cummings BM; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA., Carroll RW; Catherine E. Naber, MD, and Neil D. Fernandes, MD, are Pediatric Critical Care Fellows, Division of Pediatric Critical Care Medicine; Manuella Lahoud-Rahme, MD, is a Pediatric Cardiologist, Division of Pediatric Critical Care and Division of Pediatric Cardiology; Phoebe H. Yager, MD, is a Pediatric Critical Care Physician and Chief, Division of Pediatric Critical Care Medicine; Brian M. Cummings, MD, is Medical Director and Vice Chair, Division of Pediatrics, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; Ryan W. Carroll, MD, MPH, is Director, Global Pediatric Critical Care Medicine, and a Pediatric Critical Care Physician, Division of Pediatric Critical Care Medicine; and Allan M. Goldstein, MD, is Surgeon-in-Chief; all at MassGeneral Hospital for Children. Danielle Doucette, RRT, is a Respiratory Therapist and ECMO Coordinator, Respiratory Care Services, and Allan M. Goldstein, MD, is Chief, Division of Pediatric Surgery, Department of Surgery; both at Massachusetts General Hospital. Allan M. Goldstein is the Marshall K. Bartlett Professor of Surgery, Department of Surgery; Brian M. Cummings, Phoebe H. Yager, and Ryan W. Carroll are Assistant Professors and Manuella Lahoud-Rahme is an Instructor, Department of Pediatrics; all at Harvard Medical School. All of the authors are located in Boston, MA.
Jazyk: angličtina
Zdroj: Health security [Health Secur] 2022 Jan-Feb; Vol. 20 (1), pp. 50-57. Date of Electronic Publication: 2022 Jan 11.
DOI: 10.1089/hs.2021.0119
Abstrakt: Treatment of multisystem inflammatory syndrome in children (MIS-C) can require significant critical care resources. Our aim is to alert mixed pediatric and adult hospitals worldwide of the possibility that pediatric and adult patients may simultaneously require cannulation to extracorporeal membrane oxygenation (ECMO) for MIS-C and severe COVID-19. We conducted a retrospective review of operations required to treat cardiogenic shock in 3 pediatric patients with a diagnosis of MIS-C admitted to a single medium-sized pediatric referral center located within a large academic medical center over a 14-day period. At this time, a large number of adult patients required ECMO for severe COVID-19 at our institution. Of the 11 pediatric patients who presented with MIS-C during the first surge of 2020, 2 patients required cannulation to venoarterial extracorporeal membrane oxygenation (VA-ECMO), and a third patient developed a life-threatening arrhythmia requiring transfer to a neighboring institution for consideration of VA-ECMO when our institution's ECMO capacity had briefly been reached. Pediatric referral centers located within institutions providing ECMO to adult patients with severe COVID-19 may benefit from frequent and direct communication with their adult and regional colleagues to devise a collaborative plan for safe and timely provision of ECMO to patients with MIS-C as the ongoing pandemic continues to consume this limited, lifesaving resource.
Databáze: MEDLINE