{"title":"Coagulation and hemolysis complications in neonatal ECLS: Role of devices","authors":"Timothy M. Maul , Guillermo Herrera","doi":"10.1016/j.siny.2022.101405","DOIUrl":null,"url":null,"abstract":"<div><p><span>Neonatal extracorporeal life support<span><span> (ECLS) has enjoyed a long history of successful patient support for both cardiac and respiratory failure. The small size of this patient population has provided many technical challenges from cannulation to pumps and </span>oxygenators. This is further complicated by the relatively meager commercial options for equipment owing to the relatively low utilization of neonatal ECLS compared to adults, which has exploded following the </span></span>H1N1 epidemic and the availability of the polymethylpentene oxygenator. This paper focuses on the impact of equipment choices on thrombosis and hemolysis in neonatal ECLS and the underlying mechanisms behind them. Based upon the available evidence, it is clear neonatal ECLS requires careful attention to the selection and operation of all parts of the ECLS system. Practitioners should also be aware of the factors that increase blood cell fragility, which can impact decisions around equipment and subsequent operation.</p></div>","PeriodicalId":49547,"journal":{"name":"Seminars in Fetal & Neonatal Medicine","volume":"27 6","pages":"Article 101405"},"PeriodicalIF":2.9000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"4","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Fetal & Neonatal Medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1744165X22000841","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 4
Abstract
Neonatal extracorporeal life support (ECLS) has enjoyed a long history of successful patient support for both cardiac and respiratory failure. The small size of this patient population has provided many technical challenges from cannulation to pumps and oxygenators. This is further complicated by the relatively meager commercial options for equipment owing to the relatively low utilization of neonatal ECLS compared to adults, which has exploded following the H1N1 epidemic and the availability of the polymethylpentene oxygenator. This paper focuses on the impact of equipment choices on thrombosis and hemolysis in neonatal ECLS and the underlying mechanisms behind them. Based upon the available evidence, it is clear neonatal ECLS requires careful attention to the selection and operation of all parts of the ECLS system. Practitioners should also be aware of the factors that increase blood cell fragility, which can impact decisions around equipment and subsequent operation.
期刊介绍：
Seminars in Fetal & Neonatal Medicine (formerly Seminars in Neonatology) is a bi-monthly journal which publishes topic-based issues, including current ''Hot Topics'' on the latest advances in fetal and neonatal medicine. The Journal is of interest to obstetricians and maternal-fetal medicine specialists.
The Journal commissions review-based content covering current clinical opinion on the care and treatment of the pregnant patient and the neonate and draws on the necessary specialist knowledge, including that of the pediatric pulmonologist, the pediatric infectious disease specialist, the surgeon, as well as the general pediatrician and obstetrician.
Each topic-based issue is edited by an authority in their field and contains 8-10 articles.
Seminars in Fetal & Neonatal Medicine provides:
• Coverage of major developments in neonatal care;
• Value to practising neonatologists, consultant and trainee pediatricians, obstetricians, midwives and fetal medicine specialists wishing to extend their knowledge in this field;
• Up-to-date information in an attractive and relevant format.
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