Extracorporeal Membrane Oxygenation for Pediatric Cardiac Arrest

Author(s): JENNIE RYAN, MS, CPNP-AC

Contact Hours 1.00

CERP A 1.00

Expires Feb 01, 2018

Topics: Cardiovascular, Ethics

Population: Pediatric

Role: Staff

Fees
Member: Free
NonMember: $10.00

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Activity Summary

Extracorporeal cardiopulmonary resuscitation (ECPR) remains a promising treatment for pediatric patients in cardiac arrest unresponsive to traditional cardiopulmonary resuscitation. With veno-arterial extracorporeal support, blood is drained from the right atrium, oxygenated through the extracorporeal circuit, and transfused back to the body, bypassing the heart and lungs. The use of artificial oxygenation and perfusion thus provides the body a period of hemodynamic stability, while allowing resolution of underlying disease processes. Survival rates for ECPR patients are higher than those for traditional cardiopulmonary resuscitation (CPR), although neurological outcomes require further investigation. The impact of duration of CPR and length of treatment with extracorporeal membrane oxygenation vary in published reports. Furthermore, current guidelines for the initiation and use of ECPR are limited and may lead to confusion about appropriate use of this support. Many ethical concerns arise with this advanced form of life support. More often than not, the dilemma is not whether to withhold ECPR, but rather when to withdraw it. Although clinicians must decide if ECPR is appropriate and when further intervention is futile, the ultimate burden of choice is left to the patient’s caregivers. Offering support and guidance to the patient’s family as well as the patient is essential.

Objectives

  • Determine the difference between venovenous and venoarterial extracorporeal membrane oxygenation (ECMO)
  • Describe the benefits of extracorporeal cardiopulmonary resuscitation
  • Discuss the ethical considerations related to management of patients undergoing ECMO

Continuing Education Disclosure Statement

Successful Completion

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Disclosure

This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. Approval of a continuing education activity does not imply endorsement by AACN or ANCC of any commercial products displayed or discussed in conjunction with the activity.

Accreditation

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC's) Commission on Accreditation, ANCC Provider Number 0012 (60 min contact hour). AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing, California Provider number CEP01036 for 1.2 contact hours (50 min contact hour).

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