Standardized Therapies After Ecmo Program (Step); a Novel Approach to Pediatric Post-ECMO Care

Authors

• Rebekah K H Shappley
• Christen M Holder
• Constance E Poplos
• Pilar Anton-Martin
• Thomas Spentzas
• Toni M Whitaker
• Swati Karmarkar
• Samir H Shah
• Hitesh S Sandhu

Language

English

Publication Date

9-1-2024

Journal

The Journal of ExtraCorporeal Technology

DOI

10.1051/ject/2024009

PMID

39303130

PMCID

PMC11415033

PubMedCentral® Posted Date

9-20-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: The study objective was to characterize compliance with Standardized Therapy after ECMO Program (STEP), an intentional discharge pathway for extracorporeal membrane oxygenation (ECMO) survivors in a US pediatric hospital.

Methods: The program identified pediatric ECMO survivors before discharge, appropriate consultations were reviewed and requested, families were educated on ECMO sequelae, and ECMO summaries were sent to pediatricians. Compliance with institutional post-ECMO guidelines was evaluated before and after STEP implementation.

Results: We identified 77 ECMO survivors to hospital discharge (36 [46.8%] before and 41 [53.2%] after STEP implementation). There was a significant increase in complete (38.8% vs. 74.2%, p < 0.001) and time-appropriate neurodevelopmental testing (71.4% vs. 95.6%, p = 0.03). Significant increase in inpatient evaluations by neurology (52.7% vs. 75.6%, p = 0.03) and audiology (66.7% vs. 87.8%, p = 0.02), and in referrals for outpatient audiology (66.6 vs. 95.1%, p = 0.002), physical therapy (P.T.) (63.8% vs. 95.1%, p = 0.001), occupational therapy (O.T.) (63.8% vs. 95.1%, p = 0.001) and speech-language pathology (S.L.P.) (55.5% vs. 95.1%, p < 0.001) were noted.

Conclusion: Implementing an intentional discharge pathway for pediatric ECMO survivors (STEP) successfully increases inpatient and outpatient compliance with hospital and Extracorporeal life support organization (ELSO) follow-up guidelines. It leads to timely and complete neurodevelopmental evaluation.

Keywords

Humans, Extracorporeal Membrane Oxygenation, Female, Male, Infant, Child, Child, Preschool, Guideline Adherence, Infant, Newborn, Patient Discharge, Adolescent, Survivors, Pediatric ECMO, Follow-up care, Post-ECMO follow-up care, Intentional discharge pathway, ELSO, Neuro developmental follow-up

Published Open-Access

yes

Recommended Citation

Shappley, Rebekah K H; Holder, Christen M; Poplos, Constance E; et al., "Standardized Therapies After Ecmo Program (Step); a Novel Approach to Pediatric Post-ECMO Care" (2024). Faculty, Staff and Student Publications. 4268.
https://digitalcommons.library.tmc.edu/uthmed_docs/4268