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. 1995 Sep;73(2):F91–F94. doi: 10.1136/fn.73.2.f91

Role of ECMO in the treatment of respiratory syncytial virus bronchiolitis: a collaborative report.

J Y Khan 1, S J Kerr 1, A Tometzki 1, L Tyszczuk 1, J West 1, A Sosnowski 1, D McCrae 1, C Skeoch 1, C Davis 1, R K Firmin 1, et al.
PMCID: PMC2528496  PMID: 7583613

Abstract

AIM--To report the collaborative experience of extracorporeal membrane oxygenation (ECMO) in the treatment of respiratory syncytial virus (RSV) bronchiolitis between April 1989 and January 1995. METHODS--The medical records of patients with confirmed RSV bronchiolitis referred to three centres (Leicester, Glasgow, and Great Ormond Street) were reviewed. RESULTS--Twenty four infants were identified. Seventeen had been born prematurely (gestational range 23-40 weeks, median 30 weeks). Thirteen infants had been mechanically ventilated after birth and seven of these had evidence of bronchopulmonary dysplasia (BPD). The age of onset of RSV infection varied from three to 64 weeks (mean 17.4 weeks, median 12 weeks). Ventilation before ECMO ranged from one to 16 days and oxygenation indices at the time of referral ranged from 21-73 (mean 39). Ribavirin was used in eight of the 24 patients. Sixteen patients received venoarterial and eight veno-venous ECMO. ECMO hours ranged from 32-647 (median 196 hours). One infant died (survival rate 96%). Cranial ultrasound abnormalities were detected in three patients. However, at follow up only one of the 23 survivors had evidence of developmental delay. CONCLUSION--A group of paediatric patients in whom ECMO can be of benefit has been identified. The use of ECMO should be considered when other means of support prove unsuccessful.

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Selected References

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  1. Abman S. H., Ogle J. W., Butler-Simon N., Rumack C. M., Accurso F. J. Role of respiratory syncytial virus in early hospitalizations for respiratory distress of young infants with cystic fibrosis. J Pediatr. 1988 Nov;113(5):826–830. doi: 10.1016/s0022-3476(88)80008-8. [DOI] [PubMed] [Google Scholar]
  2. Barry W., Cockburn F., Cornall R., Price J. F., Sutherland G., Vardag A. Ribavirin aerosol for acute bronchiolitis. Arch Dis Child. 1986 Jun;61(6):593–597. doi: 10.1136/adc.61.6.593. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Dawson K., Kennedy D., Asher I., Cooper D., Cooper P., Francis P., Henry R., Le Souef P., Martin J., Masters B. The management of acute bronchiolitis. Thoracic Society of Australia and New Zealand. J Paediatr Child Health. 1993 Oct;29(5):335–337. doi: 10.1111/j.1440-1754.1993.tb00529.x. [DOI] [PubMed] [Google Scholar]
  4. Groothuis J. R., Gutierrez K. M., Lauer B. A. Respiratory syncytial virus infection in children with bronchopulmonary dysplasia. Pediatrics. 1988 Aug;82(2):199–203. [PubMed] [Google Scholar]
  5. Hall C. B., McBride J. T., Gala C. L., Hildreth S. W., Schnabel K. C. Ribavirin treatment of respiratory syncytial viral infection in infants with underlying cardiopulmonary disease. JAMA. 1985 Dec 6;254(21):3047–3051. [PubMed] [Google Scholar]
  6. Hall C. B., Powell K. R., MacDonald N. E., Gala C. L., Menegus M. E., Suffin S. C., Cohen H. J. Respiratory syncytial viral infection in children with compromised immune function. N Engl J Med. 1986 Jul 10;315(2):77–81. doi: 10.1056/NEJM198607103150201. [DOI] [PubMed] [Google Scholar]
  7. Henderson F. W., Clyde W. A., Jr, Collier A. M., Denny F. W., Senior R. J., Sheaffer C. I., Conley W. G., 3rd, Christian R. M. The etiologic and epidemiologic spectrum of bronchiolitis in pediatric practice. J Pediatr. 1979 Aug;95(2):183–190. doi: 10.1016/s0022-3476(79)80647-2. [DOI] [PubMed] [Google Scholar]
  8. Isaacs D., Moxon E. R., Harvey D., Kovar I., Madeley C. R., Richardson R. J., Levin M., Whitelaw A., Modi N. Ribavirin in respiratory syncytial virus infection. A double blind placebo controlled trial is needed. Arch Dis Child. 1988 Aug;63(8):986–990. doi: 10.1136/adc.63.8.986. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jaimovich D., Kecskes S. A. Management of reactive airway disease. Crit Care Clin. 1992 Jan;8(1):147–162. [PubMed] [Google Scholar]
  10. La Via W. V., Marks M. I., Stutman H. R. Respiratory syncytial virus puzzle: clinical features, pathophysiology, treatment, and prevention. J Pediatr. 1992 Oct;121(4):503–510. doi: 10.1016/s0022-3476(05)81135-7. [DOI] [PubMed] [Google Scholar]
  11. Lebel M. H., Gauthier M., Lacroix J., Rousseau E., Buithieu M. Respiratory failure and mechanical ventilation in severe bronchiolitis. Arch Dis Child. 1989 Oct;64(10):1431–1437. doi: 10.1136/adc.64.10.1431. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. MacDonald N. E., Hall C. B., Suffin S. C., Alexson C., Harris P. J., Manning J. A. Respiratory syncytial viral infection in infants with congenital heart disease. N Engl J Med. 1982 Aug 12;307(7):397–400. doi: 10.1056/NEJM198208123070702. [DOI] [PubMed] [Google Scholar]
  13. Meert K., Heidemann S., Abella B., Sarnaik A. Does prematurity alter the course of respiratory syncytial virus infection? Crit Care Med. 1990 Dec;18(12):1357–1359. doi: 10.1097/00003246-199012000-00009. [DOI] [PubMed] [Google Scholar]
  14. O'Rourke P. P., Stolar C. J., Zwischenberger J. B., Snedecor S. M., Bartlett R. H. Extracorporeal membrane oxygenation: support for overwhelming pulmonary failure in the pediatric population. Collective experience from the extracorporeal life support organization. J Pediatr Surg. 1993 Apr;28(4):523–529. doi: 10.1016/0022-3468(93)90610-w. [DOI] [PubMed] [Google Scholar]
  15. Panitch H. B., Callahan C. W., Jr, Schidlow D. V. Bronchiolitis in children. Clin Chest Med. 1993 Dec;14(4):715–731. [PubMed] [Google Scholar]
  16. Parrott R. H., Kim H. W., Brandt C. D., Chanock R. M. Respiratory syncytial virus in infants and children. Prev Med. 1974 Dec;3(4):473–480. doi: 10.1016/0091-7435(74)90010-3. [DOI] [PubMed] [Google Scholar]
  17. Pearson G. A., Field D. J., Firmin R. K., Sosnowski A. S. UK experience in neonatal extracorporeal membrane oxygenation. Arch Dis Child. 1992 Jul;67(7 Spec No):822–825. doi: 10.1136/adc.67.7_spec_no.822. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Price J. F. Acute and long-term effects of viral bronchiolitis in infancy. Lung. 1990;168 (Suppl):414–421. doi: 10.1007/BF02718159. [DOI] [PubMed] [Google Scholar]
  19. Rakshi K., Couriel J. M. Management of acute bronchiolitis. Arch Dis Child. 1994 Nov;71(5):463–469. doi: 10.1136/adc.71.5.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Smith D. W., Frankel L. R., Mathers L. H., Tang A. T., Ariagno R. L., Prober C. G. A controlled trial of aerosolized ribavirin in infants receiving mechanical ventilation for severe respiratory syncytial virus infection. N Engl J Med. 1991 Jul 4;325(1):24–29. doi: 10.1056/NEJM199107043250105. [DOI] [PubMed] [Google Scholar]
  21. Taber L. H., Knight V., Gilbert B. E., McClung H. W., Wilson S. Z., Norton H. J., Thurson J. M., Gordon W. H., Atmar R. L., Schlaudt W. R. Ribavirin aerosol treatment of bronchiolitis associated with respiratory syncytial virus infection in infants. Pediatrics. 1983 Nov;72(5):613–618. [PubMed] [Google Scholar]
  22. Wald E. R., Dashefsky B., Green M. In re ribavirin: a case of premature adjudication? J Pediatr. 1988 Jan;112(1):154–158. doi: 10.1016/s0022-3476(88)80143-4. [DOI] [PubMed] [Google Scholar]

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