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278 IN MEMORIAM
Paediatriki
Volume 84 | Number 3 | September - October - November - December 2021
Four monthly publication of the Greek Paediatric Society
194
EDITORIAL
Stelios Antoniadis
196
AWARDED PAPER
Lung function variability in healthy children and adolescents: the effect of age and clinical implications
Eirini Sofia Frima, Dimos Gidaris, Nikolaos Karantaglis, Grigorios Chatziparasidis, Aris Bertzouanis, Ilias Theodorakopoulos, Michael B Anthracopoulos, Sotirios Fouzas
208
RESEARCH STUDY
Respiratory Physiotherapy in premature infants at the Neonatal Intensive Care Unit
Kapali Eleni, Hristara-Papadopoulou Alexandra, Trahana Maria, Ioannis Xinias, Baltatzi Georgia, Poimenidis Onoufrios, Anastasiadou Efrosini
224
REVIEW ARTICLES
Immune thrombocytopenia: Epidemiology, diagnosis and management
Anna Papazoglou, Elpidoforos Mantadakis
238
Nutritional management of nephrotic syndrome in children
Koutsikou Niki
246
Sexuality Matters of Adolescents with Intellectual Disability: a literature review
Vasiliki Dimitrakopoulou, Οurania Tsouridi, Νikolaos Moschos, Kyriakos Platrites
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Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 Infection: A Case Study of Two Cases Lampros Fotis, Maria Papadaki, Vasilios Tsiribis, Maria-Eleni Varanaki, Panagiotis Tzanavaris, Georgios Tsolas
266
VV ECMO support as a late addition for infection-related respiratory failure in a 16month old child
Spiros Loggos, Elias Lazaros, Antonios Samothrakis, Anthi Dimoulitsa, Vana Grigorakou,Katerina babanelou, Kasi Ioannidou, Maria Maurikiou, Loria Pafitou, Fotios Mitropoulos
274
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276 BOOK PRESENTATION
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278 IN MEMORIAM
284
INSTRUCTIONS TO AUTHORS
T.
e-mail: sfouzas@upatras.gr
Correspondence
Sotirios Fouzas
Rio, Patra, 26504
T. +302610 999 980, +306944510047
e-mail: sfouzas@upatras.gr
Lung function variability in healthy children and adolescents: the effect of age and clinical implications
Eirini Sofia Frima, Dimos Gidaris, Nikolaos Karantaglis, Grigorios Chatziparasidis, Aris Bertzouanis, Ilias Theodorakopoulos, Michael B Anthracopoulos, Sotirios Fouzas
Abstract
Introduction: In adults, the long-term variability of the lung function relates to functional disorders of the respiratory system. In childhood, the presence of similar patterns remains unknown. Our aim was to evaluate the lung function variability of in healthy children and adolescents and assess the effect of age and gender.
Methods: In this multicenter study (www.luvstudy.gr; NCT04163146) participated 92 healthy non-asthmatic children aged 11.3 ± 3.5 years (range 12-18 years); they performed spirometry twice daily for three months via a portable spirometer. The coefficient of variation, amplitude and periodicity of FEV1 were evaluated. Detrended fluctuation analysis (DFA) and sample entropy analysis (SampEn) were also applied.
Eirini Sofia Frima
Aris Bertzouanis
Michael B Anthracopoulos
Sotirios Fouzas
Pediatric Respiratory Unit, Department of Pediatrics, University of Patras, Greece
Dimos Gidaris
University of Nicosia, Cyprus
Nikolaos Karantaglis
Pediatric Respiratory Unit, 3rd Department of Pediatrics, Aristotle University of Thessaloniki, Greece
Grigorios Chatziparasidis
Primary Ciliary Dyskinesia Unit, School of Medicine, University of Thessaly, Larisa, Greece
Ilias Theodorakopoulos
Department of Physics, University of Patras, Greece
Results: The range of FEV1 values decreased with age, with no differences between boys and girls. During early school age, the periodicity of FEV1 values was lower in boys (28±5.8 days) than in girls (38.4±8 days). A negative relationship was found between DFA and age (regression coefficient –0.884, P<0.001) and a positive relationship between SampEn and age (coefficient 0.860, P<0.001), with significant differences between boys and girls.
Conclusions: Healthy children present structured (i.e., non-random) fluctuations of lung function, the pattern of which depends on age and gender. With increasing age, the self-similarity of the FEV1 timeseries decreases, while their complexity increases, thus indicating an overall increase in the stability and adaptability of the respiratory system. These changes occur earlier in girls compared with boys, and may explain the increased vulnerability of younger children to environmental stimuli that trigger reversible small-airways obstruction.
Keywords: Lung function, variability, timeseries, children
Function Variability in Children (LUV) study,
(Spirobank Smart, MIR, Rome, Italy),
MatLab (MathWorks, Inc., Natick, MA, USA).
(detrended fluctuation analysis, DFA)
(sample entropy, SampEn).13
27.0 (IBM Corp., Armonk, NY,
Αποτελέσματα
± 0,12 (0,82, 0,59 - 1,02)
± 0,19 (2,03, 1,67 – 2,35)
Βιβλιογραφία
1. Spengler CM, Shea SA. Endogenous circadian rhythm of pulmonary function in healthy humans. Am J Respir Crit Care Med 2000;162:1038-1046.
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5. Thamrin C, Taylor DR, Jones SL, Suki B, Frey U. Variability of lung function predicts loss of asthma control following withdrawal of inhaled corticosteroid treatment. Thorax 2010;65:403408.
6. Thamrin C, Nydegger R, Stern G, Chanez P, Wenzel SE, Watt RA, et al. Associations between fluctuations in lung function and asthma control in two populations with differing asthma severity. Thorax 2011;66:1036-1042.
7. Kaminsky DA, Wang LL, Bates JH, Thamrin C, Shade DM, Dixon AE, et al. Fluctuation analysis of peak expiratory flow and its association with treatment failure in asthma. Am J Respir Crit Care Med 2017;195:993-999.
8. Global Initiative for Asthma. GINA: Global Strategy for asthma management and prevention, 2021. National Heart, Lung and Blood Institute. http://www.ginasthma.org.
9. Frima ES, Theodorakopoulos I, Gidaris D, Karantaglis N, Chatziparasidis G, Plotas P, et al. Lung function variability in children and adolescents with and without asthma (LUV Study):
Protocol for a prospective, nonrandomized, clinical trial. JMIR Res Protoc 2020;9(8):e20350.
10. Quanjer PH, Stanojevic S, Cole TJ, Baur X, Hall GL, Culver BH, et al. Multi-ethnic reference values for spirometry for the 3-95-yr age range: the global lung function 2012 equations. Eur Respir J. 2012;40:1324-43.
11. Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hall GL, et al. Standardization of spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement. Am J Respir Crit Care Med 2019;200:e70-e88
12. Huang NE, Shen Z, Long SR, Wu MC, Shih HH, Zheng Q, et al. The empirical mode decomposition and the Hilbert spectrum for nonlinear and non-stationary time series analysis. Proc R Soc Lond 1998;A.454:903-995.
13. Peng C-K, Mietus J, Hausdorff JM, Havlin S, Stanley HE, Goldberger AL. Long-range anticorrelations and non-Gaussian behavior of the heartbeat. Phys Rev Lett 1993;70:1343-1346.
14. Ottino JM, Muzzio FJ, Tjahjadi M, Franjione JG, Jana SC, Kusch HA. Chaos, symmetry, and self-similarity: exploiting order and disorder in mixing processes. Science 1992;257(5071):754760.
15. Sinha A, Lutter R, Xu B, Dekker T, Dierdorp B, Sterk PJ, et al. Loss of adaptive capacity in asthmatic patients revealed by biomarker fluctuation dynamics after rhinovirus challenge. Elife 2019;8:e47969.
16. Delgado-Eckert E, James A, Meier-Girard D, Kupczyk M, Andersson LI, Bossios A, et al. Lung function fluctuation patterns unveil asthma and COPD phenotypes unrelated to type 2 inflammation. J Allergy Clin Immunol 2021;148(2):407-419.
Αναπνευστική
e-mail: hristara2@hotmail. com
Correspondence
Hristara-Papadopoulou
Alexandra
T. +306942222445
e-mail: hristara2@hotmail. com
Respiratory Physiotherapy in premature infants at the Neonatal Intensive Care Unit
Kapali Eleni, Hristara-Papadopoulou Alexandra, Trahana Maria, Ioannis Xinias, Baltatzi Georgia, Poimenidis Onoufrios, Anastasiadou Efrosini
Abstract
Introduction: Technological innovations, the treatment of the surfactant factor, the advancement of respiratory support, thermoregulation and nutritional care, have contributed to the improvement of the survival of premature infants in the Intensive Care Unit for Newborns (I.C.U.N). In the modern literature, much has been said about the potentially harmful effects of the I.C.U.N environment on the neurodevelopmental maturation of premature infants, and many studies have studied the improvement of these factors. The goal of intensive care for premature infants is essentially to maintain life by providing appropriate medical support, in an environment that mimics the uterus, trying as much as possible to give experiences that were interrupted due to premature birth.
Kapali Eleni
Hellenic Society for the Protection of Rehabilitation of Persons, (ELEPAP) Thessaloniki
Hristara-Papadopoulou
Alexandra
Baltatzi Georgia
Poimenidis Onoufrios
Department of Physiotherapy, International Hellenic University
Trahana Maria
Ioannis Xinias
3rd Pediatric Clinic G.H., Hippocratic Hospital of Thessaloniki,
Anastasiadou Efrosini
Neonatal Intensive Care Unit, G.H., Hippocratic of Thessaloniki
Aim: The aim of this study is to evaluate the effectiveness of the Respiratory Physiotherapy (R.P) in stabilized preterm infants of low birth weight and short duration of gestation in I.C.U.N, supporting both the improvement and maintenance of their self-regulation and the prevention of complications. To demonstrate the effectiveness of our protocol, we collected data on vital heart rate (B.P..M) and oxygen saturation (SpO2) using a pulse oxymeter.
Methods: We took into account the history of our newborns in terms of the type of respiratory support, until their stabilization. That is, if they entered supportive mechanical ventilation (M.V), or non-invasive ventilation (N.I.V), until they stabilized and did not need any respiratory support. Fifty two (52) stabilized premature infants met the research selection criteria. Manipulations such as supine, left-to-left and prone positions, placement in fetal posture and support using a nest, deep steady tactile pressure, non-nutritional sucking with finger-feeding, created a self-regulating environment and artificially resembling supportive effect system of stabilized premature infants, directly improving and stabilizing SpO2 and B.P.M.
Results: From the results of our research we conclude that RP has a positive effect both on the improvement and maintenance of self-regulation, stabilized premature infants in I.C.U.N in SpO2 and B.P.M., and in the prevention of complications, due to their history. Also, the differences between the groups are not affected by mechanical ventilation, or non-invasive ventilation which supportive premature infants needed in the early stages of their lives in I.C.U.N, till to be characterized as stabilized premature infants.
Keywords: Stabilized premature infants, Respiratory Physiotherapy, Neonatal Intensive Care Unit, nest, deep steady tactile pressure, non-nutritional sucking
Α.Φ:
B.P.M: Beat Pulse
Measurement:
H.R: Heard Rate:
I.C.U.N: Intensive Care Unit for Newborns:
M.V: Mechanical
Ventilation: Μηχανικός
N.I.V: Non-Invasive Ventilation: Μη
R.P: Respiratory Physiotherapy: Αναπνευστική
SpO2: Saturation of Arterial Oxygen: Κορεσμός
W.O..B: Work of Breath:
WH.O: World Health Organization:
B.P.M.
Κορεσμός
* Statistically different between groups (*** p≤0.001,
Baseline
End
* Statistically different between groups (*** p≤0.001, ** p≤0.01, *p≤0.05)
* Statistically different between 2 other groups.
Ο Pessima [15]
Balaguer et al.,
Οι Lieb [44], Field,
Βιβλιογραφία
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F.
e-mail: emantada@med. duth.gr
Correspondence
Elpidoforos Mantadakis
6th Kilometer Alexandroupolis-Makris, 68100 Alexandroupolis
T. +3025513-51411
F. +3025510-30340
e-mail: emantada@med. duth.gr
Immune thrombocytopenia: Epidemiology, diagnosis and management
Anna Papazoglou, Elpidoforos Mantadakis
Summary
Immune thrombocytopenia (ITP), formerly known as idiopathic and immune thrombocytopenic purpura is an autoimmune disease characterized by isolated thrombocytopenia due to destruction of platelets covered by autoantibodies. Antibodies are directed against glycoproteins of the platelet cell membrane. The disease can be classified as newly diagnosed (<3 months), persistent (lasting 3-12 months), or chronic (lasting> 12 months). The incidence of acute ITP in children is about 4.8 cases, while that of chronic disease 0.5 cases per 100,000 children per year. Primary ITP is a diagnosis of exclusion. The clinical examination is normal except for the hemorrhagic manifestations, while the complete blood count is typically normal except for the isolated thrombocytopenia. Systemic manifestations such as fever or weight loss, as well as the detection of hepatomegaly, splenomegaly, or lymphadenopathy, indicate another underlying disease as the cause of thrombocytopenia, such as a lymphoproliferative disease, acquired immune deficiency syndrome, chronic hepatis, systemic lupus erythematosus or a lysosomal storage disease. ITP is a benign disease of childhood and only 0-4% of children experience severe bleeding that requires immediate intervention at diagnosis. In deciding whether a child with ITP should be treated with corticosteroids or intravenous γ-globin, the bleeding symptoms, platelet count, history of recent injuries, presence of headache, use of medications, and patient's lifestyle and medical insurance should be considered. Thrombopoietin receptor agonists, rituximab, and splenectomy play an important role in the treatment of patients with chronic disease.
Keywords: Immune thrombocytopenia, hemorrhage, corticosteroids, intravenous g globulin, thrombopoietin receptor agonists, splenectomy
Anna Papazoglou
Elpidoforos Mantadakis
Department of Pediatrics, Hematology-Oncology Unit, University General Hospital of Alexandroupolis
Wiskott-Aldrich, σ. Bernard Soulier,
von Willebrand
Κίρρωση ήπατος, πυλαία υπέρταση
Σπληνομεγαλία
Φάρμακα (συνταγογραφούμενα και
Μυελοίνωση
Απλαστική αναιμία
Μεγαλοβλαστική αναιμία
Νόσος Gaucher
Πρόσφατος εμβολιασμός με εμβόλιο ιλαράς-ερυθράς-παρωτίτιδας, εμβόλιο ηπατίτιδας
ITP (23).
η CVID (19).
Βαθμός IV. Σοβαρή αιμορραγική
διάθεση (πτώση Hb≥2g/dl), με έντονη
αιμορραγία βλεννογόνων (σοβαρή ρινορραγία, ουλορραγία, μηνορραγία,
μέλαινα, αιματέμεση) ή πιθανή εσωτερική
αιμορραγία, όπως πνευμονική αιμορραγία (αιμόπτυση), αίμαρθρο, μυϊκό αιμάτωμα, εγκεφαλική
Eltrombopag (Revolade®) Romiplostim (Nplate®)
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2. Cines DB, Bussel JB, Liebman HA, Luning Prak ET. The ITP syndrome: pathogenic and clinical diversity. Blood. 2009;113(26):6511–6521.
3. Kiefel V, Freitag E, Kroll H, Santoso S, Mueller-Eckhardt C. Platelet autoantibodies (IgG, IgM, IgA) against glycoproteins IIb/IIIa and Ib/IX in patients with thrombocytopenia. Ann Hematol. 1996;72(4):280–285.
4. Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113(11):2386–2393.
5. Kühne T, Buchanan GR, Zimmerman S, Michaels LA, Kohan R, Berchhtold, et al. A prospective comparative study of 2540 infants and children with newly diagnosed idiopathic thrombocytopenic purpura (ITP) from the intercontinental childhood ITP study group. J Pediatr. 2003;143(5):605–608.
6. Terrell DR, Beebe LA, Vesely SK, Neas BR, Segal JB, George JN. The incidence of immune thrombocytopenic purpura in children and adults: A critical review of published reports. Am J Hematol. 2010:85(3):174-180.
7. Zeller B, Rajantie J, Hedlund-Treutiger I, Tedgård U, Wesenberg F, Jonsson OG, et al. Childhood idiopathic thrombocytopenic purpura in the Nordic countries: Epidemiology and predictors of chronic disease: Childhood ITP in the Nordic countries. Acta Paediatr. 2007;94(2):178–184.
8. Zeller B, Helgestad J, Hellebostad M, Kolmannskog S, Nystad T, Stensvold K, et al. Immune thrombocytopenic purpura in Norway: a prospective, population-based registration. Pediatric Hematol Oncol. 2000;17(7):551–558.
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K.
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Correspondence
Koutsikou Niki
8 Ippokratous str., Penteli, 152 36
T. +30 213 2052 527
M. +30 697 008 67 53
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Nutritional management of nephrotic syndrome in children
Koutsikou Niki
Abstract
Nephrotic syndrome is a relatively common glomerular disease during childhood, characterized by the clinical triad of proteinuria, hypoalbuminaemia and oedema. The incidence of childhood nephrotic syndrome is reported as 4.7 cases per 100,000 children worldwide. Nutritional management is an important part of nephrotic syndrome’s overall management and its aims are managing signs and symptoms, as well as its complications, replacing the nutrients’ losses through the urine, improving nutritional status and reducing the risk of greater renal damage. Adequate dietary energy and protein intake is of great importance, in order to reduce the risk of proteinenergy malnutrition. Dietary fat quantity and quality, vitamins’ and minerals’ supplemental intake, dietary sodium intake and fluid consumption are also dietary management’s part. Dietary management of the nephrotic syndrome should be individualized, due to the great heterogeneity of nephrotic syndrome’s clinical manifestations in children. Over the last years, many clinical trials have been looking for a relationship between food hypersensitivity and nephrotic syndrome’s clinical manifestations’ severity, and various mechanisms explaining this relationship have been proposed. However, more clinical trials are required in order to come to a safest conclusion as far as the usefulness and the safety of an exclusive diet in children with nephrotic syndrome.
Keywords: nephrotic syndrome, children, nutritional management, energy requirements, proteins
Koutsikou Niki
Department of Nutrition, Penteli’s General Childrens’ Hospital
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e-mail:
Correspondence
Vasiliki Dimitrakopoulou
Aiolou 107, 13451
Kamatero
T.+306974257906
e-mail: dimivicky@yahoo.gr
Sexuality Matters of Adolescents with Intellectual Disability: a literature review
Vasiliki Dimitrakopoulou, Οurania Tsouridi,Νikolaos Moschos, Kyriakos Platrites
Summary
According to the World Health Organization (WHO), sexuality constitutes indefeasible part of human’s personality, it is a basic need and part of human nature. Adolescents with Intellectual Disability are capable to develop sexual behavior according to society’s rules. In 2013 the old term «Mental Retardation» was displaced by the new one «Intellectual Disability». Worries and needs of adolescents with Intellectual Disability referring to sexuality matters are so common to these of adolescents from general population. Disuse, distortion, and tolerance have characterized the efforts of sexual education for disabled people worldwide during the past years. According to bibliography, the analysis of data concerning sexuality matters of adolescents with Intellectual Disability, shows that arranged programs of sexual education should be implemented, with parallel information and counselling of their families. This review aspires to lead to a scientific and social recognition to the sexual wake-up call of adolescents with Intellectual Disability, as well as to the phenomenon of discrimination and exclusion. People with Intellectual Disability should be considered from all as gender existences with sexuality, acceptable from the society.
Keywords: Intellectual Disability, Adolescent, Sexuality
Vasiliki Dimitrakopoulou
Οurania Tsouridi
Νikolaos Moschos
Department of Psychiatry, General Hospital of Nikaia
«Agios Pantelehmon» - General Hospital of West Attica
«Agia Barbara»
Kyriakos Platrites
Cyprus Institute for Psychotherapy
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e-mail: geotsolas@gmail.com
Correspondence
Vasiliki Dimitrakopoulou
Aiolou 107, 13451
Kamatero T.+306974257906
e-mail: dimivicky@yahoo.gr
Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19 Infection: A Case Study of Two Cases
Lampros Fotis, Maria Papadaki, Vasilios Tsiribis, Maria-Eleni Varanaki, Panagiotis Tzanavaris, Georgios Tsolas
Abstract
Introduction: Multisystem inflammatory syndrome in children (MIS-C), is a novel syndrome associated with Covid-19 disease, which was first described in April 2020 in the United Kingdom. Since then, the number of patients meeting the case definitions for MIS-C has rapidly increased all over the world, with more than 2.500 cases and more than 300 deaths recorded in USA until March 2021.This new syndrome is temporally associated with COVID-19, with the development of symptoms typically about 2-6 weeks after escalation of geographically local COVID-19 incidence. Although MIS-C and Kawasaki disease present with some phenotypic similarities, there are several features distinguishing the two diseases. In patients with MIS-C, the disease course can be more severe, with many children requiring intensive care interventions. The prognosis of MIS-C is uncertain, given that it is a relatively new clinical entity and longterm follow-up studies are lacking.
Case presentation: We present two cases of pediatric patients diagnosed with MIS-C in a private hospital in Attica, which were presented with different clinical features and were both successfully treated.
Conclusion: MIS-C is a novel syndrome with multisystem involvement, presented with a variety of clinical features, for which no confirmatory diagnostic test exists. Early diagnosis and treatment of MIS-C is of great importance for patients’ best outcomes.
Keywords: Multisystem Inflammatory Syndrome, Children, COVID-19, SARS-CoV-2
Lampros Fotis
Maria Papadaki
Vasilios Tsiribis
Maria-Eleni Varanaki
Panagiotis Tzanavaris
Georgios Tsolas
Pediatric Clinic of Metropolitan Hospital
MIS-C: Multisystem inflammatory syndrome in children
CDC: Centers for Disease Control and Prevention
WHO: World Health Organization
ΤΕΠ:
BMI: Body Mass Index
PCR:
CT:
(Na, K, Cl,
AST, ALT, ALP, χολερυθρίνη) Έλεγχος με PCR
για SARS – CoV-2.
+ λευκοκυττάρωση, λεμφοπενία (<1000), θρομβοπενία (<150000), υπονατριαιμία (<135 mmol/L) ή υποαλβουμιναιμία Προχωρήστε στο Βήμα 2
2 BNP, τροπονίνη, προκαλσιτονίνη, φερριτίνη, D-dimers, PT, PTT, LDH, ινωδογόνο,
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e-mail: dr_spylog@yahoo. co.uk.
Correspondence
Spiros Loggos, 6 Erythroy Staurou St, Marousi, 15123, Athens, Greece
Τ. +306945720693
e-mail: dr_spylog@yahoo. co.uk.
VV ECMO support as a late addition for infection-related respiratory failure in a 16month old child
Spiros Loggos, Elias Lazaros, Antonios Samothrakis, Anthi Dimoulitsa, Vana Grigorakou, Katerina babanelou, Kasi Ioannidou, Maria Maurikiou, Loria Pafitou, Fotios Mitropoulos
Abstract
Late initiation of VV ECMO support, in a patient who has been supported with mechanical ventilation more than 7 days, for respiratory failure, has been shown to have poor results. Several papers have highlighted the unfavorable outcomes of previously ventilated patients, prior to initiating ECMO support, and the relative contraindication as shown in the latest ELSO guidelines, make such a decision difficult. Herein, we present our successful effort, of supporting a 16month old child, with Human metapneumovirus (HMPV) infection. Our patient had been intubated and ventilated, with inotropic support for 10 days and a Murray score of 5, before commencing VV ECMO, with a 16F Avalon cannula, through the right jugular vein. He was supported for 7 days, before emergency decannulation was performed, due to the presence of clots in the circuit. He was discharged home 10 days following decannulation. It was one more successful result, of our department in managing pediatric patients , with both respiratory and cardiovascular conditions requiring ECMO support.
Spiros Loggos
Fotios Mitropoulos
1st Dep of Congenital cardiac surgery Mitera hospital
Elias Lazaros
Antonios Samothrakis
Perfusion department Mitera Hospital
Anthi Dimoulitsa
Vana Grigorakou
Katerina babanelou
Kasi Ioannidou
Maria Maurikiou
Loria Pafitou
Cardiothoracic PICU, Mitera Hospital
VV ECMO: Late initiation, Respiratory failure
ECMO: extracorporeal membrane oxygenator
VV ECMO: venovenous
VA ECMO: veno arterial
ECHO: echocardiography
ARDS: Acute respiratory distress syndrome
ELSO: Extracorporeal Life Support Organization
ECPR: Extra-corporeal cardiopulmonary resuscitation
PEEP: positive end-expiratory pressure
Βιβλιογραφία
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2) Christoph Fisser, Felix Gerhardinger, Thomas Müller, Maximilian Malfertheiner, Alois Philipp, Maik Foltan, Dirk Lunz, Matthias Lubnow. Predictors for successful weaning from V-V ECMO. European Respiratory Journal 2020 56: 3432; DOI: 10.1183/13993003.congress-2020.3432.
3) Soumagne, Thibaud; Grillet, Franck; Piton, Gaël; Winiszewski, Hadrien; Capellier, Gilles Extracorporeal Membrane Oxygenation in Severe Acute Respiratory Distress Syndrome: Possible Late Indication for Coronavirus Disease. Crit Care Explor ; 2(10): e0240, 2020 Oct.
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4)Farid Azizov, Julia Merkle, Javid Fatullayev, Kaveh Eghbalzadeh, Ilija Djordjevic, Carolyn Weber, Sergey Saenko, Axel Kroener, Mohamed Zeriouh, Anton Sabashnikov, Gerardus Bennink, Thorsten Wahlers. Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure. Vol 11, Supplement 6 (April 2019): Journal of Thoracic Disease (Mechanical Circulatory Support for Heart and Lung Failure)
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Senior Resident in Pediatrics and Postdoctoral fellow in Neonatology, Dept. of Pediatrics, Loyola University Medical Center, Chicago, III.
Postdoctoral fellow in Human Genetics and Pediatrics,
Yale University School of Medicine, New Haven, Con.
Professor of Pediatrics
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