New GUIDELINES from a joint effort of the American Heart Association and American Thoracic Society specify the use of ECMO for Pulmonary Hypertension.
For many years ECMOlogists have utilized ECMO for Pulmonary Hypertension of both the newborn as well as pediatric patients. Some have utilized ECMO for Pulmonary Hypertension in adults as well. For the newborn with PPHN there has been fairly consistent use of ECMO. But the question of which patient and disease process to use ECMO for related to Pulmonary Hypertension can often lead to significant debate. This is especially true for the Diaphragmatic Hernia patient.
The new “First Guidelines Issued for Children” suggest use of ECMO for Pulmonary Hypertension in the diaphragmatic hernia patient with severe pulmonary hypertension that is not responding to medical therapy. The full text report also specifies use of ECMO for Pulmonary Hypertension in the newborn PPHN population. It also specifies use of NO for this patient population when their OI (Oxygen Index) reaches 25.
Oxygen Index can easily be calculated by using this formula.
FiO2 x MAP x 100
Take a few minutes to read through the entire full text report for a nice comprehensive review of the primary issues related to Pulmonary Hypertension in Children and how it differs from the issues seen in Adult patients.