Extracorporeal membrane oxygenation (ECMO)
Extracorporeal Life Support (also known as extracorporeal membrane oxygenation, ECMO) is cardiopulmonary bypass pumping done for prolonged periods of time at a child's bedside. Cardiopulmonary bypass was originally developed to allow surgery on the pediatric heart during "open heart surgery." However, we have been able to adapt the technology to support children who suffer pulmonary failure from a large variety of causes.
Children with overwhelming pneumonias, those born with severe congenital anomalies such as diaphragmatic hernia with pulmonary hypoplasia, or children who have heart failure following cardiac surgery may be candidates for ECMO support. In all of these children, ECMO circulates a child's blood so that oxygen can be supplied to the body and gaseous wastes removed, allowing time for healing for a child's damaged lungs.
These highly complex procedures are done in the Neonatal Intensive Care Unit or the Pediatric Intensive Care Unit at Children's Memorial. Staff members in the Division of Pediatric General Surgery, as well as a host of other supporting services, provide consultation. Full parental consent is sought prior to the initiation of the ECMO procedure, which generally lasts from several days to as long as three to four weeks.
Pediatric surgeons are available to families to keep them fully informed of a child's progress when undergoing this innovative but technologically demanding support. Ancillary care services and surgery are provided as necessary, and pediatric surgery maintains long-term follow-up services for all of the children who have undergone ECMO.
Pediatric trauma/burn care
Pediatric trauma remains the number one health care problem of children in America. In fact, pediatric trauma deaths exceed the next most common cause of childhood fatalities by four times.
Children's Memorial Hospital is a City of Chicago-designated level one pediatric trauma center, which means that the hospital is staffed and equipped to handle the most severely injured children. Approximately 800 trauma victims are seen at the hospital each year; half are admitted to the hospital. Pediatric general surgeons direct the trauma service and provide care via the immediate response team. They admit the children to the hospital, with few exceptions, on the pediatric surgery service for the first 24 to 48 hours of care.
Because trauma can involve a host of body parts and organ systems, the trauma team draws on the expertise of all the hospital's specialists. The services of orthopaedic surgery, neurosurgery, and intensive care are those services most often used in concert with pediatric surgery for multiple-trauma victims. All are available for care and consultation. However, pediatric surgeons, as the initial providers of injury care, often take the lead in arranging care conferences or consultations for children admitted for trauma to Children's Memorial Hospital.