2024
Comprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study.
Hughes T, Treffalls R, Koek W, Dalton H, Karam O, Meyer A. Comprehensive secondary analysis of thrombotic events in pediatric patients receiving extracorporeal membrane oxygenation: A prospective cohort study. Perfusion 2024, 2676591241289358. PMID: 39352407, DOI: 10.1177/02676591241289358.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationMultiple thrombotic eventsThrombotic eventsMembrane oxygenationPediatric extracorporeal membrane oxygenationMulti-center prospective studyEvaluate predictive factorsDays of therapyPlatelet transfusion volumeProspective cohort studyTransfusion volumeBinomial regressionPediatric patientsProlonged ECMOPlatelet volumePredictive factorsProspective studyUnivariate analysisAnti-XaCohort studySeverity scoreHigh riskPatientsAntithrombin IIIScoring toolProphylactic Transfusion Strategies in Children Supported by Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference
Nellis M, Moynihan K, Sloan S, Delaney M, Kneyber M, DiGeronimo R, Alexander P, Muszynski J, Gehred A, Lyman E, Karam O, in collaboration with the Pediatric Critical Care Blood Research Network A. Prophylactic Transfusion Strategies in Children Supported by Extracorporeal Membrane Oxygenation: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference. Pediatric Critical Care Medicine 2024, 25: e25-e34. PMID: 38959357, PMCID: PMC11216389, DOI: 10.1097/pcc.0000000000003493.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationProphylactic transfusion strategyTransfusion strategyMembrane oxygenationProphylactic blood product transfusionsPediatric extracorporeal membrane oxygenationConsensus statementPediatric ECMO patientsBlood product transfusionExpert consensus statementPractice statementsStandardized data extraction formProphylactic transfusionECMO patientsProduct transfusionModified Delphi consensusWeak recommendationConsensus conferenceRecommendations AssessmentData extraction formDelphi processStudy assessed useModified Delphi processLiterature searchDelphi consensusExecutive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference*
Alexander P, Bembea M, Cashen K, Cheifetz I, Dalton H, Himebauch A, Karam O, Moynihan K, Nellis M, Ozment C, Raman L, Rintoul N, Said A, Saini A, Steiner M, Thiagarajan R, Watt K, Willems A, Zantek N, Barbaro R, Steffen K, Vogel A, Almond C, Anders M, Annich G, Brandão L, Chandler W, Delaney M, DiGeronimo R, Emani S, Gadepalli S, Garcia A, Haileselassie B, Hyslop R, Kneyber M, Kreuziger L, Le J, Loftis L, McMichael A, McMullan D, Monagle P, Nicol K, Paden M, Patregnani J, Priest J, Raffini L, Ryerson L, Sloan S, Teruya J, Yates A, Gehred A, Lyman E, Muszynski J, in collaboration with the Pediatric Acute Lung Injury and Sepsis Investigators Network T. Executive Summary: The Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE (PEACE) Consensus Conference*. Pediatric Critical Care Medicine 2024, 25: 643-675. PMID: 38959353, PMCID: PMC11216385, DOI: 10.1097/pcc.0000000000003480.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationCritically ill childrenClinical managementClinical management of neonatesManaging extracorporeal membrane oxygenationConsensus statementExpert-based statementsIll childrenCochrane Library (CENTRALManagement of neonatesManagement of anticoagulationCochrane Library databasesExpert consensus statementSystematic reviewPractice statementsMembrane oxygenationNonprocedural bleedingClinical trialsLibrary databasesConsensus conferencePerioperative careRecommendations AssessmentAnticoagulationClinical careGeneral carePriorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference
Muszynski J, Bembea M, Gehred A, Lyman E, Cashen K, Cheifetz I, Dalton H, Himebauch A, Karam O, Moynihan K, Nellis M, Ozment C, Raman L, Rintoul N, Said A, Saini A, Steiner M, Thiagarajan R, Watt K, Willems A, Zantek N, Barbaro R, Steffen K, Vogel A, Alexander P, Alexander P, Bembea M, Cashen K, Cheifetz I, Dalton H, Himebauch A, Karam O, Moynihan K, Nellis M, Ozment C, Raman L, Rintoul N, Said A, Saini A, Steiner M, Thiagarajan R, Watt K, Willems A, Zantek N, Barbaro R, Steffen K, Vogel A, Almond C, Anders M, Annich G, Brandão L, Chandler W, Delaney M, DiGeronimo R, Emani S, Gadepalli S, Garcia A, Haileselassie B, Himebauch A, Hyslop R, Kneyber M, Kreuziger L, Le J, Loftis L, McMichael A, McMullan D, Monagle P, Nicol K, Paden M, Patregnani J, Priest J, Raffini L, Ryerson L, Sloan S, Teruya J, Yates A, Gehred A, Lyman E, Muszynski J. Priorities for Clinical Research in Pediatric Extracorporeal Membrane Oxygenation Anticoagulation From the Pediatric Extracorporeal Membrane Oxygenation Anticoagulation CollaborativE Consensus Conference. Pediatric Critical Care Medicine 2024, 25: e78-e89. PMID: 38959362, PMCID: PMC11216398, DOI: 10.1097/pcc.0000000000003488.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationCritically ill neonatesIll neonatesExtracorporeal membrane oxygenation anticoagulationManagement of extracorporeal membrane oxygenationConsensus conferenceSystematic reviewSystematic review of MEDLINECochrane Library databasesReview of MEDLINECare of neonatesMembrane oxygenationChild Health and Nutrition Research Initiative methodologyHemostasis managementLibrary databasesNeonatesConsensus statementClinical recommendationsAnticoagulationClinical careClinical researchEmbaseCochraneExpert panelPediatricClinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia.
Labarinas S, Norbisrath K, Johnson D, Meliones J, Greenleaf C, Salazar J, Karam O. Clinical outcomes in critically ill children on extracorporeal membrane oxygenation with severe thrombocytopenia. Perfusion 2024, 2676591241247981. PMID: 38626382, DOI: 10.1177/02676591241247981.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationExtracorporeal membrane oxygenation daysCritically ill childrenSevere thrombocytopeniaPlatelet countPlatelet transfusionsMembrane oxygenationIll childrenMortality rateDuration of extracorporeal membrane oxygenationAssociated with in-hospital mortality ratesExtracorporeal membrane oxygenation durationSingle-center retrospective studyPlatelet transfusion strategyFrequent platelet transfusionsIn-hospital mortality rateAssociated with bleedingTransfusion strategyAssociated with higher proportionsMedian weightMulticenter studyRetrospective studyClinical outcomesOn-ECMOThrombocytopenia
2023
105: Clinical Outcomes in Critically Ill Children on Extracorporeal Membrane Oxygenation with Severe Thrombocytopenia.
Labarinas S, Singh K, Meliones J, Johnson D, Greenleaf C, Salazar J, Karam O. 105: Clinical Outcomes in Critically Ill Children on Extracorporeal Membrane Oxygenation with Severe Thrombocytopenia. ASAIO Journal 2023, 69: 57-57. DOI: 10.1097/01.mat.0000990932.67126.dc.Peer-Reviewed Original ResearchEfficacy of Prostacyclin Anticoagulation in Critically Ill Patients Requiring Extracorporeal Support: A Systematic Review and Meta-Analysis
Aldairi N, Al Ali A, Alabdulqader M, Al Jeraisy M, Cyrus J, Karam O. Efficacy of Prostacyclin Anticoagulation in Critically Ill Patients Requiring Extracorporeal Support: A Systematic Review and Meta-Analysis. Cureus 2023, 15: e39967. PMID: 37416033, PMCID: PMC10320736, DOI: 10.7759/cureus.39967.Peer-Reviewed Original ResearchContinuous renal replacement therapyExtracorporeal membrane oxygenationMolecular adsorbent recirculating systemRenal replacement therapyHypotensive eventsCircuit lifespanReplacement therapyAnticoagulation strategiesMeta-analysisThrombotic eventsExtracorporeal supportSystematic reviewAssociated with fewer bleeding eventsControl seriesProportion of bleedingMortality rateCritically ill childrenCritically ill patientsStatistically significant decreaseMultiple electronic databasesRandomized controlled trialsRisk of biasBleeding eventsMembrane oxygenationSupport modalitiesAnticoagulation and hemostasis on extracorporeal membrane oxygenation
Carmona C, Nellis M, Karam O. Anticoagulation and hemostasis on extracorporeal membrane oxygenation. Current Opinion In Pediatrics 2023, 35: 297-302. PMID: 36974451, DOI: 10.1097/mop.0000000000001247.Peer-Reviewed Original ResearchConceptsHemostatic transfusionsMembrane oxygenationPlatelet transfusionsProspective randomized trialsOptimal anticoagulation strategyExtracorporeal membrane oxygenationPlatelet transfusion strategyRecent systematic reviewHemostatic changesAnticoagulation strategiesFrequent complicationMost patientsThrombotic complicationsTransfusion strategyRandomized trialsCareful titrationObservational studyTransfusionSystematic reviewAnticoagulationECMOComplicationsBleedingTwo-fold decreaseRiskFirst nosocomial infections in children supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO)
Cousin V, Rodriguez-Vigouroux R, Karam O, Rimensberger P, Posfay-Barbe K. First nosocomial infections in children supported by veno-arterial extracorporeal membrane oxygenation (VA-ECMO). BMC Pediatrics 2023, 23: 89. PMID: 36823601, PMCID: PMC9948414, DOI: 10.1186/s12887-023-03908-3.Peer-Reviewed Original ResearchConceptsVA-ECMO supportPediatric intensive care unitMedian timeClinical signsMedian PICU LOSNosocomial infection occurrenceUrinary tract infectionVentilator-associated pneumoniaExtracorporeal membrane oxygenationIntensive care unitPaucity of dataPICU lengthPICU LOSRefractory shockVA-ECMOTract infectionsMedian ageMembrane oxygenationSternotomy infectionsCare unitRetrospective studySevere infectionsFirst infectionMortality rateInfection occurrenceCardiac manifestations of multisystem inflammatory syndrome of children after SARS-CoV-2 infection: a systematic review and meta-analysis.
Carmona C, Kuziez M, Freitas C, Cyrus J, Bain J, Karam O. Cardiac manifestations of multisystem inflammatory syndrome of children after SARS-CoV-2 infection: a systematic review and meta-analysis. Cardiology In The Young 2023, 33: 2319-2327. PMID: 36762563, DOI: 10.1017/s104795112300015x.Peer-Reviewed Original ResearchConceptsMultisystem inflammatory syndromeInflammatory syndromeCardiac manifestationsSystematic reviewSARS-CoV-2 infectionCommon cardiac manifestationVentricular systolic dysfunctionSARS-CoV-2 pandemicCoronary abnormalitiesSystolic dysfunctionHospital periodMembrane oxygenationOvid EmbasePatient outcomesOvid MEDLINEChild patientsLarge cohortAccurate prevalenceElectronic searchMortality rateLiterature databasesPrevalenceSyndromeFull textManifestationsEpidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database study
Nellis M, An A, Mahmood H, Prishtina F, Hena Z, Karam O. Epidemiology of anticoagulation for children supported by extracorporeal membrane oxygenation in the United States: A Pediatric Hospital Information System database study. Perfusion 2023, 39: 536-542. PMID: 36606508, DOI: 10.1177/02676591221151027.Peer-Reviewed Original ResearchDirect thrombin inhibitorMembrane oxygenationPediatric Health Information System databaseThrombin inhibitorsHealth Information System databaseDifferent anticoagulant regimensRetrospective cohort studyUse of anticoagulationUse of bivalirudinPercent of encountersOccurrence of thrombosisRisk of thrombosisLarge administrative databaseMajority of childrenEligible encountersCardiac indicationsHeparin anticoagulationAnticoagulation regimensCohort studyMedian ageSystemic anticoagulationAnticoagulant regimensProspective studyPatient populationAdministrative databases
2022
Effect of Platelet Transfusions on Extracorporeal Life Support Oxygenator’s Function
Chegondi M, Vijayakumar N, Badheka A, Karam O. Effect of Platelet Transfusions on Extracorporeal Life Support Oxygenator’s Function. Frontiers In Pediatrics 2022, 10: 826477. PMID: 35321010, PMCID: PMC8936087, DOI: 10.3389/fped.2022.826477.Peer-Reviewed Original ResearchExtracorporeal membrane oxygenationPediatric intensive care unitPlatelet transfusionsOxygenator functionECMO supportVeno-arterial extracorporeal membrane oxygenationOnly independent factorSubgroup of patientsIntensive care unitAnticoagulation strategiesCommon complicationMembrane oxygenationCare unitRetrospective studyMain complicationsLowest quartileTransfusionIndependent factorsMmHgECMO oxygenatorROC curveComplicationsPatientsChildrenRegression models
2021
Transfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass: A Secondary Analysis of a Clinical Database
Hanson SJ, Karam O, Birch R, Goel R, Patel RM, Sola-Visner M, Sachais BS, Hauser RG, Luban NLC, Gottschall J, Josephson CD, Hendrickson JE, Karafin MS, Nellis ME, Lung A. Transfusion Practices in Pediatric Cardiac Surgery Requiring Cardiopulmonary Bypass: A Secondary Analysis of a Clinical Database. Pediatric Critical Care Medicine 2021, 22: 978-987. PMID: 34261944, PMCID: PMC8570986, DOI: 10.1097/pcc.0000000000002805.Peer-Reviewed Original ResearchConceptsCongenital heart diseaseBiventricular surgeryCardiopulmonary bypass surgeryHeart diseaseMedian internationalBypass surgeryMembrane oxygenationPlatelet countBlood componentsVentricular surgeryHemoglobin valuesBlood Institute Recipient EpidemiologyDonor Evaluation Study-IIIHigher median platelet countNormal international normalized ratioIntraoperative platelet transfusionLimited physiologic reserveMultiple blood productsPretransfusion platelet countU.S. hospitalsMedian platelet countBlood component transfusionBlood component usageExtracorporeal membrane oxygenationInternational normalized ratioEpidemiology of the Use of Hemostatic Agents in Children Supported by Extracorporeal Membrane Oxygenation: A Pediatric Health Information System Database Study
Nellis ME, Vasovic LV, Goel R, Karam O. Epidemiology of the Use of Hemostatic Agents in Children Supported by Extracorporeal Membrane Oxygenation: A Pediatric Health Information System Database Study. Frontiers In Pediatrics 2021, 9: 673613. PMID: 34041211, PMCID: PMC8141845, DOI: 10.3389/fped.2021.673613.Peer-Reviewed Original ResearchHemostatic blood productsECMO daysPercent of childrenBlood productsMembrane oxygenationPediatric Health Information System Database StudyPediatric Health Information System databaseHealth Information System databaseUse of TXAHospital mortality rateRetrospective observational studyU.S. children's hospitalsExtracorporeal membrane oxygenationMedian ageChildren's HospitalMedian lengthHemostatic measuresInformation System databaseObservational studyECMODatabase studyHigh riskMortality rateHemostatic agentsFactor VIIaTransfusion management for children supported by extracorporeal membrane oxygenation
Karam O, Nellis ME. Transfusion management for children supported by extracorporeal membrane oxygenation. Transfusion 2021, 61: 660-664. PMID: 33491189, DOI: 10.1111/trf.16272.Peer-Reviewed Original Research
2020
Anti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis
Willems A, Roeleveld PP, Labarinas S, Cyrus JW, Muszynski JA, Nellis ME, Karam O. Anti-Xa versus time-guided anticoagulation strategies in extracorporeal membrane oxygenation: a systematic review and meta-analysis. Perfusion 2020, 36: 501-512. PMID: 32862767, PMCID: PMC8216320, DOI: 10.1177/0267659120952982.Peer-Reviewed Original ResearchConceptsAnticoagulation strategiesMortality rateThrombotic eventsObservational studySystematic reviewProportion of bleedingType of ECMOExtracorporeal membrane oxygenationMultiple electronic databasesLower mortality rateMembrane oxygenationPatientsElectronic databasesECMOThrombosisSignificant differencesXaBleedingReviewMortalityStudyEpidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation.
Karam O, Goel R, Dalton H, Nellis ME. Epidemiology of Hemostatic Transfusions in Children Supported by Extracorporeal Membrane Oxygenation. Critical Care Medicine 2020, 48: e698-e705. PMID: 32697511, DOI: 10.1097/ccm.0000000000004417.Peer-Reviewed Original ResearchConceptsExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkChest tube outputMembrane oxygenationHemostatic transfusionsRBC transfusionTransfusion doseExtracorporeal membrane oxygenation daysLarge observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkTube outputPlatelet transfusion doseObservational cohort studyHuman Development Collaborative Pediatric Critical Care Research NetworkInternational normalized ratioTotal platelet countPartial thromboplastin timeAntithrombin levelsCohort studyConsecutive childrenTransfusion strategyChest tubePlatelet countHemostatic testingPediatric Plasma and Platelet Transfusions on Extracorporeal Membrane Oxygenation: A Subgroup Analysis of Two Large International Point-Prevalence Studies and the Role of Local Guidelines.
Nellis ME, Saini A, Spinella PC, Davis PJ, Steiner ME, Tucci M, Cushing M, Demaret P, Stanworth SJ, Leteurtre S, Karam O. Pediatric Plasma and Platelet Transfusions on Extracorporeal Membrane Oxygenation: A Subgroup Analysis of Two Large International Point-Prevalence Studies and the Role of Local Guidelines. Pediatric Critical Care Medicine 2020, 21: 267-275. PMID: 31644453, PMCID: PMC7060816, DOI: 10.1097/pcc.0000000000002160.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentBlood TransfusionChildChild, PreschoolExtracorporeal Membrane OxygenationFemaleHemorrhageHumansInfantInfant, NewbornIntensive Care Units, PediatricInternational Normalized RatioMalePlasmaPlatelet CountPlatelet TransfusionPractice Guidelines as TopicProspective StudiesSurveys and QuestionnairesConceptsExtracorporeal membrane oxygenationMembrane oxygenationPlatelet transfusionsTotal platelet countPlasma transfusionPlatelet countSubgroup analysisInstitutional protocolMedian increaseInternational point prevalence studyPediatric extracorporeal membrane oxygenationTotal median doseInternational normalized ratioML/Point prevalence studyPlatelet count valuesScreening weekMedian doseMild coagulopathyNormalized ratioInterventional studyLocal guidelinesObservational studyMedian reductionTransfusion
2019
Quantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome.
Nellis ME, Dalton H, Karam O. Quantifiable Bleeding in Children Supported by Extracorporeal Membrane Oxygenation and Outcome. Critical Care Medicine 2019, 47: e886-e892. PMID: 31449061, PMCID: PMC8608374, DOI: 10.1097/ccm.0000000000003968.Peer-Reviewed Original ResearchConceptsChest tube bleedingExtracorporeal membrane oxygenationCollaborative Pediatric Critical Care Research NetworkMembrane oxygenationChest tubeClinical outcomesPlatelet countML/Large observational cohort studyEunice Kennedy Shriver National InstituteCritical Care Research NetworkPICU-free daysPercent of patientsObservational cohort studyWorse clinical outcomesHuman Development Collaborative Pediatric Critical Care Research NetworkMembrane oxygenation specialistsHospital mortalityTransfusion volumeCohort studyHeparin doseConsecutive patientsThrombotic eventsPediatric institutionHemostatic tests
2016
Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation
Brunner A, Dubois N, Rimensberger PC, Karam O. Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation. Critical Care Research And Practice 2016, 2016: 9521091. PMID: 27006826, PMCID: PMC4781941, DOI: 10.1155/2016/9521091.Peer-Reviewed Original ResearchECMO-cardiopulmonary resuscitationExtracorporeal membrane oxygenationMembrane oxygenationNormal cognitive statusECMO initiationHospital staySpastic quadriplegiaPrognostic factorsSuccessful weaningClinical outcomesPoor outcomeAppropriate indicationsPrognostic criteriaCardiopulmonary resuscitationSurvival ratePatientsCognitive statusLower lactateOverall rateResuscitationSurvivalChildrenSurvivorsOxygenationShorter length