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Feng CY, Kolchinski A, Kapoor S, Khanduja S, Hwang J, Suarez JI, Geocadin RG, Kim BS, Whitman G, Cho SM. Prevalence and Neurological Outcomes of Comatose Patients With Extracorporeal Membrane Oxygenation. J Cardiothorac Vasc Anesth 2024:S1053-0770(24)00449-X. [PMID: 39060155 DOI: 10.1053/j.jvca.2024.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 07/02/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
OBJECTIVES To investigate prevalence, risk factors, and in-hospital outcomes of comatose extracorporeal membrane oxygenation (ECMO) patients. DESIGN Retrospective observational. SETTING Tertiary academic hospital. PARTICIPANTS Adults received venoarterial (VA) or venovenous (VV) ECMO support between November 2017 and April 022. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS We defined 24-hour off sedation as no sedative infusion (except dexmedetomidine) or paralytics administration over a continuous 24-hour period while on ECMO. Off-sedation coma (comaoff) was defined as a Glasgow Coma Scale score of ≤8 after achieving 24-hour off sedation. On-sedation coma (comaon) was defined as a Glasgow Coma Scale score of ≤8 during the entire ECMO course without off sedation for 24 hours. Neurological outcomes were assessed at discharge using the modified Rankin scale (good, 0-3; poor, 4-6). We included 230 patients (VA-ECMO 143, 65% male); 24-hour off sedation was achieved in 32.2% VA-ECMO and 26.4% VV-ECMO patients. Among all patients off sedation for 24 hours (n = 69), 56.5% VA-ECMO and 52.2% VV-ECMO patients experienced comaoff. Among those unable to be sedation free for 24 hours (n = 161), 50.5% VA-ECMO and 17.2% VV-ECMO had comaon. Comaoff was associated with poor outcomes (p < 0.05) in VA-ECMO and VV-ECMO groups, whereas comaon only impacted the VA-ECMO group outcomes. In a multivariable analysis, requirement of renal replacement therapy was an independent risk factor for comaoff after adjusting for ECMO configuration, after adjusting for ECMO configuration, acute brain injury, pre-ECMO partial pressure of oxygen in arterial blood, partial pressure of carbon dioxide in arterial blood, pH, and bicarbonate level (worst value within 24 hours before cannulation). CONCLUSIONS Comaoff was common and associated with poor outcomes at discharge. Requirement of renal replacement therapy was an independent risk factor.
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Affiliation(s)
- Cheng-Yuan Feng
- Division of Neurosciences Critical Care, Departments of Neurology and Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Critical Care Medicine and TriHealth Neuroscience Institute, Cincinnati, OH
| | | | - Shrey Kapoor
- Johns Hopkins University School of Medicine, Baltimore, MD
| | - Shivalika Khanduja
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jaeho Hwang
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Jose I Suarez
- Division of Neurosciences Critical Care, Departments of Neurology and Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Romergryko G Geocadin
- Division of Neurosciences Critical Care, Departments of Neurology and Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bo Soo Kim
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Glenn Whitman
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Sung-Min Cho
- Division of Cardiac Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Division of Neurosciences Critical Care, Departments of Neurology and Neurosurgery, and Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
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Erklauer JC, Lai YC. The State of the Field of Pediatric Multimodality Neuromonitoring. Neurocrit Care 2024; 40:1160-1170. [PMID: 37864125 DOI: 10.1007/s12028-023-01858-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 09/08/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The use of multimodal neuromonitoring in pediatrics is in its infancy relative to adult neurocritical care. Multimodal neuromonitoring encompasses the amalgamation of information from multiple individual neuromonitoring devices to gain a more comprehensive understanding of the condition of the brain. It allows for adaptation to the changing state of the brain throughout various stages of injury with potential to individualize and optimize therapies. METHODS Here we provide an overview of multimodal neuromonitoring in pediatric neurocritical care and its potential application in the future. RESULTS Multimodal neuromonitoring devices are key to the process of multimodal neuromonitoring, allowing for visualization of data trends over time and ideally improving the ability of clinicians to identify patterns and find meaning in the immense volume of data now encountered in the care of critically ill patients at the bedside. Clinical use in pediatrics requires more study to determine best practices and impact on patient outcomes. Potential uses include guidance for targets of physiological parameters in the setting of acute brain injury, neuroprotection for patients at high risk for brain injury, and neuroprognostication. Implementing multimodal neuromonitoring in pediatric patients involves interprofessional collaboration with the development of a simultaneous comprehensive program to support the use of multimodal neuromonitoring while maintaining the fundamental principles of the delivery of neurocritical care at the bedside. CONCLUSIONS The possible benefits of multimodal neuromonitoring are immense and have great potential to advance the field of pediatric neurocritical care and the health of critically ill children.
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Affiliation(s)
- Jennifer C Erklauer
- Divisions of Critical Care Medicine and Pediatric Neurology and Developmental Neurosciences, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.
| | - Yi-Chen Lai
- Division of Critical Care Medicine, Department of Pediatrics, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA
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Joye R, Cousin VL, Wacker J, Hoskote A, Gebistorf F, Tonna JE, Rycus PT, Thiagarajan RR, Polito A. Death by Neurologic Criteria in Children Undergoing Extracorporeal Cardiopulmonary Resuscitation: Retrospective Extracorporeal Life Support Organization Registry Study, 2017-2021. Pediatr Crit Care Med 2024; 25:e149-e157. [PMID: 37982691 PMCID: PMC10903996 DOI: 10.1097/pcc.0000000000003406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVES To determine factors associated with brain death in children treated with extracorporeal cardiopulmonary resuscitation (E-cardiopulmonary resuscitation). DESIGN Retrospective database study. SETTINGS Data reported to the Extracorporeal Life Support Organization (ELSO), 2017-2021. PATIENTS Children supported with venoarterial extracorporeal membrane oxygenation (ECMO) for E-cardiopulmonary resuscitation. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Data from the ELSO Registry included patient characteristics, blood gas values, support therapies, and complications. The primary outcome was brain death (i.e., death by neurologic criteria [DNC]). There were 2,209 children (≥ 29 d to < 18 yr of age) included. The reason for ECMO discontinuation was DNC in 138 patients (6%), and other criteria for death occurred in 886 patients (40%). Recovery occurred in 1,109 patients (50%), and the remaining 76 patients (4%) underwent transplantation. Fine and Gray proportional subdistribution hazards' regression analyses were used to examine the association between variables of interest and DNC. Age greater than 1 year ( p < 0.001), arterial blood carbon dioxide tension (Pa co2 ) greater than 82 mm Hg ( p = 0.022), baseline lactate greater than 15 mmol/L ( p = 0.034), and lactate 24 hours after cannulation greater than 3.8 mmol/L ( p < 0.001) were independently associated with greater hazard of subsequent DNC. In contrast, the presence of cardiac disease was associated with a lower hazard of subsequent DNC (subdistribution hazard ratio 0.57 [95% CI, 0.39-0.83] p = 0.004). CONCLUSIONS In children undergoing E-cardiopulmonary resuscitation, older age, pre-event hypercarbia, higher before and during ECMO lactate levels are associated with DNC. Given the association of DNC with hypercarbia following cardiac arrest, the role of Pa co2 management in E-cardiopulmonary resuscitation warrants further studies.
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Affiliation(s)
- Raphael Joye
- Pediatric Cardiology Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Vladimir L Cousin
- Pediatric Intensive Care Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Julie Wacker
- Pediatric Cardiology Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Aparna Hoskote
- Cardiac Intensive Care Unit, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Fabienne Gebistorf
- Pediatric Intensive Care Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
| | - Joseph E Tonna
- Division of Cardiothoracic Surgery, Department of Surgery, University of Utah Health, Salt Lake City, UT
- Department of Emergency Medicine, University of Utah Health, Salt Lake City, UT
| | - Peter T Rycus
- Extracorporeal Life Support Organization, Ann Arbor, MI
| | - Ravi R Thiagarajan
- Division of Cardiac Critical Care, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Angelo Polito
- Pediatric Intensive Care Unit, Department of Woman, Child, and Adolescent Medicine, Geneva University Hospital, Geneva, Switzerland
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Deng B, Ying J, Mu D. Subtypes and Mechanistic Advances of Extracorporeal Membrane Oxygenation-Related Acute Brain Injury. Brain Sci 2023; 13:1165. [PMID: 37626521 PMCID: PMC10452596 DOI: 10.3390/brainsci13081165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/27/2023] Open
Abstract
Extracorporeal membrane oxygenation (ECMO) is a frequently used mechanical cardiopulmonary support for rescuing critically ill patients for whom conventional medical therapies have failed. However, ECMO is associated with several complications, such as acute kidney injury, hemorrhage, thromboembolism, and acute brain injury (ABI). Among these, ABI, particularly intracranial hemorrhage (ICH) and infarction, is recognized as the primary cause of mortality during ECMO support. Furthermore, survivors often suffer significant long-term morbidities, including neurocognitive impairments, motor disturbances, and behavioral problems. This review provides a comprehensive overview of the different subtypes of ECMO-related ABI and the updated advance mechanisms, which could be helpful for the early diagnosis and potential neuromonitoring of ECMO-related ABI.
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Affiliation(s)
- Bixin Deng
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
| | - Junjie Ying
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China;
| | - Dezhi Mu
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China;
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, Chengdu 610041, China;
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Tasker RC. Editor's Choice Articles for July. Pediatr Crit Care Med 2023; 24:537-540. [PMID: 37409895 DOI: 10.1097/pcc.0000000000003302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
This is another excellent issue of Pediatric Critical Care Medicine (PCCM) for July; congratulations to our authors and many thanks to all reviewers. This month, my Editor's Choice articles cover three topics: clinical pathophysiology in pediatric patients supported using extracorporeal membrane oxygenation (ECMO); unplanned extubation of endotracheal tubes in pediatric cardiac ICU (CICU) patients; and sepsis biomarkers in the low-middle income (LMIC) resource setting. The PCCM Connections for Readers focuses on a novel pediatric theme in lung mechanics physiology, i.e., mechanical power in pediatric acute respiratory distress syndrome (PARDS).
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Affiliation(s)
- Robert C Tasker
- orcid.org/0000-0003-3647-8113
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, MA
- Selwyn College, Cambridge University, Cambridge, United Kingdom
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Transcranial Doppler microemboli and acute brain injury in extracorporeal membrane oxygenation: A prospective observational study. JTCVS Tech 2022; 15:111-122. [PMID: 36276670 PMCID: PMC9579875 DOI: 10.1016/j.xjtc.2022.07.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/14/2022] [Accepted: 07/26/2022] [Indexed: 11/21/2022] Open
Abstract
Objective Extracorporeal membrane oxygenation (ECMO) carries a high morbidity of acute brain injury (ABI) with resultant mortality increase. Transcranial Doppler (TCD) allows real-time characterization of regional cerebral hemodynamics, but limited data exist on the interpretation of microembolic signals (MES) in ECMO. Methods This prospective cohort study was conducted at a single tertiary care center, November 2017 through February 2022, and included all adult patients receiving venoarterial (VA) and venovenous (VV) ECMO undergoing TCD examinations, which all included MES monitoring. Results Of 145 patients on ECMO who underwent at least 1 TCD examination, 100 (68.9%) patients on VA-ECMO received 187 examinations whereas 45 (31.1%) patients on VV-ECMO received 65 examinations (P = .81). MES were observed in 35 (35.0%) patients on VA-ECMO and 2 (4.7%) patients on VV-ECMO (P < .001), corresponding to 46 (24.6%) and 2 (3.1%) TCD examinations, respectively. MES were present in 29.4% of patients on VA-ECMO without additional cardiac support, compared with 38.1% with intra-aortic balloon pump and 57.1% with left ventricular assist device, but these differences were not statistically significant (P = .39; P = .20, respectively). Presence or number of MES was not associated with VA-ECMO cannulation mode (23.4% MES presence in peripheral cannulation vs 25.8% in central cannulation, P = .80). In both VA- and VV-ECMO, MES presence or number was not associated with presence of clot or fibrin in the ECMO circuit or with any studied hemodynamic, laboratory, or ECMO parameters at the time of TCD. ABI occurred in 38% and 31.1% of patients on VA- and VV-ECMO, respectively. In multivariable logistic regression analyses, neither ABI nor a composite outcome of arterial thromboembolic events was associated with presence or number of MES in VA- ECMO. Conclusions TCD analysis in a large cohort of patients on ECMO demonstrates a significant number of MES, especially in patients on VA-ECMO with intra-aortic balloon pump, and/or left ventricular assist device. However, clinical associations and significance of TCD MES remain unresolved and warrant further correlation with systematic imaging and long-term neurologic follow-up.
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Wang L, Wu R. Clinical Effectiveness of Pre-hospital and In-hospital Optimized Emergency Care Procedures for Patients With Acute Craniocerebral Trauma. Front Surg 2022; 8:830571. [PMID: 35111807 PMCID: PMC8801443 DOI: 10.3389/fsurg.2021.830571] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/20/2021] [Indexed: 11/23/2022] Open
Abstract
Acute craniocerebral injury is a common traumatic disease in clinical practice, characterized by rapid changes in condition and a high rate of death and disability. Early and effective emergency care throughout the pre-hospital and in-hospital period is the key to reducing the rate of death and disability and promoting the recovery of patients. In this study, we conducted an observational study of 130 patients with acute craniocerebral injury admitted between May 2020 and May 2021. Patients were randomly divided into a regular group and an optimization group of 65 patients each, with patients in the regular group receiving the conventional emergency care model and patients in the optimization group receiving the pre-hospital and in-hospital optimal emergency care process for intervention. In this study, we observed and compared the time taken to arrive at the scene, assess the condition, attend to the patient and provide emergency care, the success rate of emergency care within 48 h, the interleukin-6 (IL-6), interleukin-8 (IL-8), and intercellular adhesion molecule-1 (ICAM-1) after admission and 1 day before discharge, the National Institute of Health Stroke Scale (NIHSS) and the Short Form 36-item Health Survey (SF-36) after resuscitation and 1 day before discharge, and the complications of infection, brain herniation, central hyperthermia, and electrolyte disturbances in both groups. We collected and statistically analyzed the recorded data. The results showed that the time taken to arrive at the consultation site, assess the condition, receive the consultation, provide first aid was significantly lower in the optimized group than in the regular group (P < 0.05); the success rate of treatment was significantly higher in the optimized group than in the regular group (P < 0.05). In both groups, IL-6, IL-8, and ICAM-1 decreased on the day before discharge compared with the day of rescue, with the levels of each index lower in the optimization group than in the regular group (P < 0.05); the NIHSS scores decreased and the SF-36 scores increased on the day before discharge compared with the successful rescue in both groups, with the NIHSS scores in the optimization group lower than in the regular group and the SF-36 scores higher than in the control group (P < 0.05). The overall complication rate in the optimization group was significantly lower than that in the regular group (P < 0.05). This shows that optimizing pre-hospital and in-hospital emergency care procedures can significantly shorten the time to emergency care for patients with acute craniocerebral injury, increase the success rate, reduce inflammation, improve neurological function and quality of life, reduce the occurrence of complications, and improve patient prognosis.
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Affiliation(s)
- Lili Wang
- Department of Emergency, The Nanhua Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
| | - Rong Wu
- Department of Outpatients, The Nanhua Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang, China
- *Correspondence: Rong Wu
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Apostolidou S, Harbauer T, Lasch P, Biermann D, Hempel M, Lütgehetmann M, Pfefferle S, Herrmann J, Rüffer A, Reinshagen K, Kozlik-Feldmann R, Gieras A, Kniep I, Oh J, Singer D, Ebenebe CU, Kobbe R. Fatal COVID-19 in a Child with Persistence of SARS-CoV-2 Despite Extensive Multidisciplinary Treatment: A Case Report. CHILDREN-BASEL 2021; 8:children8070564. [PMID: 34208887 PMCID: PMC8304245 DOI: 10.3390/children8070564] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/27/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023]
Abstract
Critical Coronavirus disease 2019 (COVID-19) developed in a 7-year-old girl with a history of dystrophy, microcephaly, and central hypothyroidism. Starting with gastrointestinal symptoms, the patient developed severe myocarditis followed by progressive multiple organ failure complicated by Pseudomonas aeruginosa bloodstream infection. Intensive care treatment consisting of invasive ventilation, drainage of pleural effusion, and high catecholamine therapy could not prevent the progression of heart failure, leading to the implantation of venoarterial extracorporeal life support (VA-ECLS) and additional left ventricle support catheter (Impella® pump). Continuous venovenous hemofiltration (CVVH) and extracorporeal hemadsorption therapy (CytoSorb®) were initiated. Whole exome sequencing revealed a mutation of unknown significance in DExH-BOX helicase 30 (DHX30), a gene encoding a RNA helicase. COVID-19 specific antiviral and immunomodulatory treatment did not lead to viral clearance or control of hyperinflammation resulting in the patient’s death on extracorporeal life support-(ECLS)-day 20. This fatal case illustrates the potential severity of pediatric COVID-19 and suggests further evaluation of antiviral treatment strategies and vaccination programs for children.
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Affiliation(s)
- Sofia Apostolidou
- Division of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, Germany; (S.A.); (T.H.); (D.S.); (C.U.E.)
| | - Theresa Harbauer
- Division of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, Germany; (S.A.); (T.H.); (D.S.); (C.U.E.)
| | - Peter Lasch
- Pediatric Intensive Care Medicine, Department of Pediatrics, Clinic Bremen-Mitte, Bremen Hospital Group, 28205 Bremen, Germany;
| | - Daniel Biermann
- Departments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany; (D.B.); (A.R.); (R.K.-F.)
| | - Maja Hempel
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Marc Lütgehetmann
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (M.L.); (S.P.)
| | - Susanne Pfefferle
- Institute for Medical Microbiology, Virology and Hygiene, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany; (M.L.); (S.P.)
| | - Jochen Herrmann
- Section of Pediatric Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Children’s Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - André Rüffer
- Departments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany; (D.B.); (A.R.); (R.K.-F.)
| | - Konrad Reinshagen
- Department of Pediatric Surgery, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Rainer Kozlik-Feldmann
- Departments of Pediatric Cardiology and Pediatric Cardiac Surgery, Clinic for Children’s Heart Medicine, University Heart and Vascular Center Hamburg, 20246 Hamburg, Germany; (D.B.); (A.R.); (R.K.-F.)
| | - Anna Gieras
- Department of Immunology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Inga Kniep
- Institute of Legal Medicine, University Medical Center Hamburg-Eppendorf, 22529 Hamburg, Germany;
| | - Jun Oh
- Department of Pediatric Nephrology, University Children’s Hospital, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany;
| | - Dominique Singer
- Division of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, Germany; (S.A.); (T.H.); (D.S.); (C.U.E.)
| | - Chinedu Ulrich Ebenebe
- Division of Neonatology and Pediatric Critical Care Medicine, University Children’s Hospital, University Medical Center Eppendorf, 20246 Hamburg, Germany; (S.A.); (T.H.); (D.S.); (C.U.E.)
| | - Robin Kobbe
- First Department of Medicine, Division of Infectious Diseases, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Correspondence: ; Tel.: +49-1-522-281-5646
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Identifying Injury to Improve Care in Infant Extracorporeal Membrane Oxygenation: Why Autopsy Is Important. Pediatr Crit Care Med 2021; 22:334-336. [PMID: 33657617 DOI: 10.1097/pcc.0000000000002624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Tasker RC. Editor's Choice Articles for March. Pediatr Crit Care Med 2021; 22:229-230. [PMID: 33657610 DOI: 10.1097/pcc.0000000000002694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Robert C Tasker
- orcid.org/0000-0003-3647-8113
- Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts
- Selwyn College, Cambridge University, United Kington
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