The need for ECMO in a paediatric burns patient

Mrs Kristen Storey1, Dr  Bronwyn Griffin2, Professor Roy Kimble1,2

1Lady Cilento Children’s Hospital, South Brisbane, Australia, 2Centre for Children’s Burns and Trauma Research, South Brisbane, Australia

Extracorporeal membrane oxygenation (ECMO) can be a lifesaving modality for children with respiratory failure. There is however, very little current literature documenting the use of ECMO in paediatric burns. We present a case study of a 3 year old child who sustained a 17% scald burn. Five days post burn, she deteriorated quite quickly while on the ward. She suffered from Acute Respiratory Distress Syndrome (ARDS), requiring admission to Paediatric Intensive Care Unit. She quickly deteriorated requiring ventilation, within 24hrs she had progressed to the oscillator. Day 2 within PICU saw further cardio- respiratory deterioration requiring VA ECMO.

We are fortunate that within our hospital we have an Extracorporeal life support team (ECLS) that has the ability to react within minutes of receiving a call. This child required ECMO for a period of nine days. While initial thoughts were that she would require skin grafts to the majority of the burn, due to her illness it was unsafe to perform this. She successfully healed within 44 days and has only required scar management in the form of pressure garments and silicone gel.

Without the ECLS team, the outcome for this child could have been very different. This is the first case with burns we have had within our hospital that has require ECMO treatment, however it emphasises the importance of having access to these critical teams.

I am the Clinical Nurse Consultant at the Lady Cilento Children’s Hospital in Brisbane

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