Robyn J. Meyer

University of Arizona

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Robert A. Berg

Children's Hospital of Philadelphia

Andreas Theodorou

Umeå University

Joseph R. Custer

Madigan Army Medical Center

Joshua Malo

University of Arizona

Marc Berg

Lucile Packard Children's Hospital

Richard L. Donnerstein

University of Arizona

Gail M. Annich

Hospital for Sick Children

Jarrod Mosier

University of Arizona

Patrick D. Brophy

University of Rochester

Norma J. Maxvold

Children's Hospital of Richmond at VCU

Cooperative Institutions

University of Arizona

University of Michigan–Ann Arbor

Banner - University Medical Center Tucson

University of Colorado Denver

University of Western Australia

Children's Hospital of Philadelphia

Boston Children's Hospital

Children's Hospital Colorado

University of Colorado Anschutz Medical Campus

Pulmonary Associates

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Pediatric Extracorporeal Life Support After High Frequency Ventilation: Predictors of Survival

ASAIO Journal (2002)

Robyn J. Meyer Frank W. Moler Norma J. Maxvold Gail M. Annich Folafoluwa O. Odetola

Previous studies of extracorporeal life support in pediatric patients have identified variables associated with survival. However, none of these studies focused on extracorporeal life support after failure of high frequency ventilation (HFV). In the present study, we determined variables associated with survival for pediatric respiratory failure patients who received HFV prior to extracorporeal life support, using data reported to the Extracorporeal Life Support Organization Registry from 1992 to 1998. Patients with neonatal diagnoses, immune compromising conditions, or congenital cardiac defects were excluded. The 243 patients who met inclusion criteria had a 58% survival rate (95% CI 48–66%). The mean age was 22 ± 39 months. Mean duration of mechanical ventilation prior to extracorporeal life support was 6.6 ± 5.8 days. Venoarterial extracorporeal life support was used in 72% of the patients; venovenous in 28%. The survival rate for the subset of patients with an oxygenation index greater than 42 cm H2O/torr on HFV (n = 122) was not significantly different from the overall sample. We determined that lower mean airway pressure, lower pressure amplitude, decreased oxygenation index, increased PaO2, and increased oxygen saturation on HFV were associated with increased survival in patients who were subsequently treated with extracorporeal life support.

Extracorporeal

Life support

10.1097/00002480-200209000-00005

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Evaluating hyperosmolar therapy for hyperosmolar disease*

Pediatric Critical Care Medicine (2005)

Robyn J. Meyer

Pediatric Critical Care Medicine: March 2005 - Volume 6 - Issue 2 - p 228-229 doi: 10.1097/01.PCC.0000154951.44684.64

10.1097/01.pcc.0000154951.44684.64

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Construction of a Reusable, High-Fidelity Model to Enhance Extracorporeal Membrane Oxygenation Training Through Simulation

Advances in Neonatal Care (2014)

Jess L. Thompson Lisa M. Grisham Jeanne Schulte Scott Chris Mogan Hannes Prescher

Initiation of extracorporeal membrane oxygenation (ECMO) is stressful, especially for inexperienced extracorporeal life support providers. The main objective of this study was to create a novel, reusable mannequin for high-fidelity simulation of ECMO initiation. We modified a Laerdal neonatal mannequin (SimNewB; Stavanger, Norway) so that it could be used to simulate an ECMO initiation. A simulation of a neonatal patient suffering from meconium aspiration was performed in the pediatric intensive care unit, and participants included new extracorporeal life support specialists in addition to the composition of the clinical ECMO team. A total of 17 individuals participated in the neonatal ECMO initiation simulation. Questionnaire results showed that 88% of participants felt better prepared to assist in an ECMO initiation after the simulation. All participants (100%) agreed that the modified mannequin and the environment were realistic and that this simulation helps teamwork and communication in future initiations of ECMO. Simulation can be used for the prevention, identification, and reduction of anxiety-related crisis situations that novice providers may infrequently encounter during routine clinical use of mechanical circulatory support. Use of a reusable, high-fidelity mannequin may be beneficial for effective team training of complex pediatric ECMO-related procedures.

Life support

Simulation training

Blood oxygenation

10.1097/anc.0000000000000054

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