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Article: Realizing Potential: Pediatric Extracorporeal Membrane Oxygenation Needs Common Adverse Event Definitions to Improve Outcomes.

Alexander, Peta M A / Habet, Victoria / Barbaro, Ryan P

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 24, Issue 6, Page(s) 528–530

MeSH term(s)	Child ; Humans ; Infant ; Extracorporeal Membrane Oxygenation/adverse effects ; Retrospective Studies ; Hospital Mortality
Language	English
Publishing date	2023-06-01
Publishing country	United States
Document type	Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S. ; Editorial ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, P.H.S. ; Comment
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003270
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Article: The authors reply.

Ündar, Akif / Kunselman, Allen R / Barbaro, Ryan P / Alexander, Peta / Patel, Krishna / Thomas, Neal J

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2024 Volume 25, Issue 1, Page(s) e60–e61

Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003401
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Zs.A 5600: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Lactic acidosis and multisystem organ failure following ibuprofen overdose requiring haemodialysis.

Pollack, Blythe E / Barbaro, Ryan P / Selewski, David T / Carlton, Erin F

Drug and therapeutics bulletin

2023 Volume 61, Issue 7, Page(s) 108–111

MeSH term(s)	Humans ; Acidosis, Lactic/chemically induced ; Acidosis, Lactic/therapy ; Ibuprofen/adverse effects ; Drug Overdose/therapy ; Metformin ; Drug-Related Side Effects and Adverse Reactions ; Renal Dialysis ; Hypoglycemic Agents
Chemical Substances	Ibuprofen (WK2XYI10QM) ; Metformin (9100L32L2N) ; Hypoglycemic Agents
Language	English
Publishing date	2023-01-17
Publishing country	England
Document type	Journal Article
ZDB-ID	80242-6
ISSN	1755-5248 ; 0012-6543
ISSN (online)	1755-5248
ISSN	0012-6543
DOI	10.1136/dtb.2022.244281.rep
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Article ; Online: Big Kids or Little Adults? Acute Lung Injury Research in Adolescents and Young Adults.

Kohne, Joseph G / Iwashyna, Theodore J / Flori, Heidi R / Barbaro, Ryan P

Annals of the American Thoracic Society

2023 Volume 20, Issue 8, Page(s) 1096–1098

MeSH term(s)	Humans ; Adolescent ; Young Adult ; Acute Lung Injury/diagnosis ; Acute Lung Injury/therapy
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2717461-X
ISSN	2325-6621 ; 1943-5665 ; 2325-6621
ISSN (online)	2325-6621 ; 1943-5665
ISSN	2325-6621
DOI	10.1513/AnnalsATS.202302-097IP
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Article: Outcomes After Extracorporeal Membrane Oxygenation in Children With COVID-19.

MacLaren, Graeme / Barbaro, Ryan P / Di Nardo, Matteo

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 24, Issue 5, Page(s) 430–432

MeSH term(s)	Child ; Humans ; Infant ; Extracorporeal Membrane Oxygenation ; COVID-19/therapy ; Retrospective Studies
Language	English
Publishing date	2023-05-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003142
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Zs.A 5600: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Extracorporeal Membrane Oxygenation in Pediatric Acute Respiratory Distress Syndrome: From the Second Pediatric Acute Lung Injury Consensus Conference.

Rambaud, Jérome / Barbaro, Ryan P / Macrae, Duncan J / Dalton, Heidi J

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 24, Issue 12 Suppl 2, Page(s) S124–S134

Abstract: Objectives: To systematically review and assimilate literature on children receiving extracorporeal membrane oxygenation (ECMO) support in pediatric acute respiratory distress syndrome (PARDS) with the goal of developing an update to the Pediatric Acute ...

Abstract	Objectives: To systematically review and assimilate literature on children receiving extracorporeal membrane oxygenation (ECMO) support in pediatric acute respiratory distress syndrome (PARDS) with the goal of developing an update to the Pediatric Acute Lung Injury Consensus Conference recommendations and statements about clinical practice and research. Data sources: Electronic searches of MEDLINE (Ovid), Embase (Elsevier), and CINAHL Complete (EBSCOhost). Study selection: The search used a medical subject heading terms and text words to capture studies of ECMO in PARDS or acute respiratory failure. Studies using animal models and case reports were excluded from our review. Data extraction: Title/abstract review, full-text review, and data extraction using a standardized data collection form. Data synthesis: The Grading of Recommendations Assessment, Development, and Evaluation approach was used to identify and summarize evidence and develop recommendations. There were 18 studies identified for full-text extraction. When pediatric data was lacking, adult and neonatal data from randomized clinical trials and observational studies were considered. Six clinical recommendations were generated related to ECMO indications, initiation, and management in PARDS. There were three good practice statements generated related to ECMO indications, initiation, and follow-up in PARDS. Two policy statements were generated involving the impact of ECMO team organization and training in PARDS. Last, there was one research statement. Conclusions: Based on a systematic literature review, we propose clinical management, good practice and policy statements within the domains of ECMO indications, initiation, team organization, team training, management, and follow-up as they relate to PARDS.
MeSH term(s)	Humans ; Extracorporeal Membrane Oxygenation ; Respiratory Distress Syndrome/therapy ; Acute Lung Injury/therapy
Language	English
Publishing date	2023-01-20
Publishing country	United States
Document type	Systematic Review ; Journal Article
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003164
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Zs.A 5600: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: ECMO support for COVID-19: a balancing act - Authors' reply.

Barbaro, Ryan P / MacLaren, Graeme / Brodie, Daniel

Lancet (London, England)

2021 Volume 397, Issue 10269, Page(s) 95

MeSH term(s)	COVID-19 ; Cohort Studies ; Extracorporeal Membrane Oxygenation ; Humans ; Registries ; SARS-CoV-2
Language	English
Publishing date	2021-01-09
Publishing country	England
Document type	Letter ; Research Support, N.I.H., Extramural ; Comment
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(20)32517-4
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Article ; Online: Noninvasive Ventilation Before Intubation and Mortality in Patients Receiving Extracorporeal Membrane Oxygenation for COVID-19: An Analysis of the Extracorporeal Life Support Organization Registry.

Giani, Marco / Rezoagli, Emanuele / Barbaro, Ryan P / Riera, Jordi / Bellani, Giacomo / Brochard, Laurent / Combes, Alain / Foti, Giuseppe / Brodie, Daniel

ASAIO journal (American Society for Artificial Internal Organs : 1992)

2024

Abstract: ... supported with BiPAP were intubated later (4.3 vs. 3.3 days, p < 0.001) and showed higher unadjusted ... hospital mortality (51.7% vs. 44.9%, p < 0.001). The use of BiPAP before intubation and time from hospital admission ...

Abstract	Bilevel-positive airway pressure (BiPAP) is a noninvasive respiratory support modality which reduces effort in patients with respiratory failure. However, it may increase tidal ventilation and transpulmonary pressure, potentially aggravating lung injury. We aimed to assess if the use of BiPAP before intubation was associated with increased mortality in adult patients with coronavirus disease 2019 (COVID-19) who received venovenous extracorporeal membrane oxygenation (ECMO). We used the Extracorporeal Life Support Organization Registry to analyze adult patients with COVID-19 supported with venovenous ECMO from January 1, 2020, to December 31, 2021. Patients treated with BiPAP were compared with patients who received other modalities of respiratory support or no respiratory support. A total of 9,819 patients from 421 centers were included. A total of 3,882 of them (39.5%) were treated with BiPAP before endotracheal intubation. Patients supported with BiPAP were intubated later (4.3 vs. 3.3 days, p < 0.001) and showed higher unadjusted hospital mortality (51.7% vs. 44.9%, p < 0.001). The use of BiPAP before intubation and time from hospital admission to intubation resulted as independently associated with increased hospital mortality (odds ratio [OR], 1.32 [95% confidence interval {CI}, 1.08-1.61] and 1.03 [1-1.06] per day increase). In ECMO patients with severe acute respiratory failure due to COVID-19, the extended use of BiPAP before intubation should be regarded as a risk factor for mortality.
Language	English
Publishing date	2024-01-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	759982-1
ISSN	1538-943X ; 0162-1432 ; 1058-2916
ISSN (online)	1538-943X
ISSN	0162-1432 ; 1058-2916
DOI	10.1097/MAT.0000000000002132
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Uk I Zs.199: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)
Zs.B 2435: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular ab Jg. 2022: Lesesaal (EG)

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Article: Centrifugal or Roller Blood Pumps for Neonatal Venovenous Extracorporeal Membrane Oxygenation: Extracorporeal Life Support Organization Database Comparison of Mortality and Morbidity.

Ündar, Akif / Kunselman, Allen R / Barbaro, Ryan P / Alexander, Peta / Patel, Krishna / Thomas, Neal J

Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

2023 Volume 24, Issue 8, Page(s) 662–669

Abstract: ... 53; 95% CI, 0.33-0.84; p < 0.008). Thrombosis and clots in the circuit components were also ... associated with lesser odds of survival (OR, 0.28; 95% CI, 0.16-0.60; p < 0.001). We failed to show ... that hemolysis was an independent variable for survival (OR, 0.60; 95% CI, 0.31-1.19; p = 0.14). The primary ...

Abstract	Objectives: To investigate outcomes associated with conventional roller or centrifugal pumps during neonatal venovenous extracorporeal membrane oxygenation (ECMO). Our primary hypothesis is that in comparison with conventional roller-pump support, centrifugal pump use is associated with greater odds of survival. Our secondary hypothesis is that centrifugal pump use is associated with lesser odds of complications. Design: Retrospective cohort identified using the Extracorporeal Life Support Organization (ELSO) registry 2016 to 2020 dataset. Setting: All ECMO centers reporting to the ELSO registry. Patients: All neonates (≤ 28 d) supported with venovenous ECMO and cannulated via right internal jugular vein using dual-lumen venovenous cannulas and polymethyl pentene membrane oxygenators. Interventions: None. Measurements and main results: A total of 612 neonates (centrifugal, n = 340; conventional roller, n = 272) were included in the analysis. Using a multivariable logistic regression model, centrifugal pump use-as opposed to roller pump use-was associated with lesser odds of survival (odds ratio [OR], 0.53; 95% CI, 0.33-0.84; p < 0.008). Thrombosis and clots in the circuit components were also associated with lesser odds of survival (OR, 0.28; 95% CI, 0.16-0.60; p < 0.001). We failed to show that hemolysis was an independent variable for survival (OR, 0.60; 95% CI, 0.31-1.19; p = 0.14). The primary diagnosis of neonatal aspiration/meconium aspiration is associated with more than seven-fold greater odds of survival (OR, 7.57; 95% CI, 4.02-15.74; p < 0.001). Conclusions: Contrary to our hypotheses, conventional roller pump use was associated with greater odds of survival. While thrombosis and clots in circuit components were independent variables for lesser odds of survival, further research is needed better to understand the use of centrifugal pumps in neonatal practice.
MeSH term(s)	Female ; Humans ; Infant, Newborn ; Extracorporeal Membrane Oxygenation/adverse effects ; Retrospective Studies ; Meconium Aspiration Syndrome ; Oxygenators, Membrane ; Morbidity
Language	English
Publishing date	2023-04-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2052349-X
ISSN	1947-3893 ; 1529-7535
ISSN (online)	1947-3893
ISSN	1529-7535
DOI	10.1097/PCC.0000000000003251
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Article ; Online: Children with severe sepsis: relationship between community level income and morbidity and mortality.

Phelps, Kayla B / Gebremariam, Acham / Andrist, Erica / Barbaro, Ryan P / Freed, Gary L / Carlton, Erin F

Pediatric research

2023 Volume 94, Issue 2, Page(s) 837–844

Abstract: ... days [IQR 4-18]; p < 0.0001). However, there was no difference after adjusting for multiple covariates ...

Abstract	Background: Health disparities surrounding pediatric severe sepsis outcomes remains unclear. We aimed to measure the relationship between indicators of socioeconomic status and mortality, hospital length of stay (LOS), and readmission rates among children hospitalized with severe sepsis. Methods: Children 0-18 years old, hospitalized with severe sepsis in the Nationwide Readmissions Database (2016-2018) were included. The primary exposure was median household income by ZIP Code of residence, divided into quartiles. Results: We identified 15,214 index pediatric severe sepsis hospitalizations. There was no difference in hospital mortality rate or readmission rate across income quartiles. Among survivors, patients in Q1 (lowest income) had a 2 day longer LOS compared to those in Q4 (Median 10 days [IQR 4-21] vs 8 days [IQR 4-18]; p < 0.0001). However, there was no difference after adjusting for multiple covariates. Conclusions: Children living in Q1 had a 2 day longer LOS versus their peers in Q4. This was not significant on multivariable analysis, suggesting income quartile is not driving this difference. As pediatric severe sepsis remains an important source of morbidity and mortality in critically ill children, more sensitive metrics of socioeconomic status may better elucidate any disparities. Impact: Children with severe sepsis living in the lowest income ZIP Codes may have longer hospital stays compared to peers in higher income communities. More precise metrics of socioeconomic status are needed to better understand health disparities in pediatric severe sepsis.
MeSH term(s)	Humans ; Child ; Infant, Newborn ; Infant ; Child, Preschool ; Adolescent ; Retrospective Studies ; Income ; Hospitalization ; Sepsis/therapy ; Morbidity
Language	English
Publishing date	2023-02-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	4411-8
ISSN	1530-0447 ; 0031-3998
ISSN (online)	1530-0447
ISSN	0031-3998
DOI	10.1038/s41390-023-02500-w
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