Showing posts with label ecmo. Show all posts
Showing posts with label ecmo. Show all posts

Wednesday, February 10, 2010

Congenital Diaphragmatic Hernia Hospitals - http://www.cdhhospitals.org

CHERUBS new web site:


includes: our Adopt A Hospital Program, a list of CDH clinics, ECMO Center, Fetal Center and members of the International CDH Study Group


CDH Adopt A Hospital Program

CHERUBS Adopt A Hospital Program

Provide Information & Support To Families Affected By Congenital Diaphragmatic Hernia



CDH Hospital Adoption Kit


Would you like to help families affected by Congenital Diaphragmatic Hernia? Would you like to do something in honor or in memory of a cherub? CHERUBS has created a new program that will soon be helping CDH families across the country.

How does it work?  You make a $100 donation to CHERUBS and we order and put together the materials and send them to the hospital in honor / memory of your cherub.


CHERUBS Adopt A Hospital Care Package Includes:




Each item (except the CDH ribbon pins) is labeled with a sticker that says "Donated in honor of ________" or "Donated in memory of _________"

These items are then available to all CDH parents admitted into these hospitals. Upon joining CHERUBS, new parents will soon receive more information and support through our CHERUBS H.O.P.E. program.

These items are an invaluable source of support and information for families affected by Congenital Diaphragmatic Hernia. Because there are so many hospitals, CHERUBS cannot possibly afford to donate to all hospitals and we are inviting our members and the general public to help us to help CDH families.

Your donation is tax-deductible!





 

Monday, September 28, 2009

News Article - Scotland sets up ECMO expert group

http://thegovmonitor.com/world_news/britain/scotland-sets-up-ecmo-expert-group-6906.html

Scotland sets up ECMO expert group

Source: Scottish Government Posted on: 27th September 2009

Health Secretary Nicola Sturgeon today announced the establishment of an expert group to consider the medium to long term provision of adult ECMO treatment in Scotland.

Scotland already has provision of ECMO for children and heart surgery patients. This group will consider the need for ECMO for adults who may require longer term critical care for the purpose of respiratory support.

Scotland’s current arrangements allow patients to receive ECMO treatment where clinically necessary. Scotland’s specialists liaise with UK colleagues in this field and work with the commissioned UK co-ordinating centre in Leicester and with similar European centres.

Treatments such as ECMO require major resource and input from specialist nursing, medical and technical personnel (eg blood transfusion and laboratory services). It is important that any decision made on future provision is not to the detriment of other services such as cardiac surgery.

The key remit of the expert group is:

* To consider the findings of the recent CESAR trial and previously published evidence for the use of ECMO in adults.
* To take evidence from leading experts regarding the efficacy and safety of ECMO treatment in adults.
* Having considered this evidence, to provide recommendations to the Cabinet Secretary for Health and Wellbeing regarding current and future ECMO provision in Scotland.

The Group will be Chaired by Dr Simon Mackenzie, President of the Scottish Intensive Care Society. Dr Mackenzie will be joined on the Group by a number of leading clinicians in this field from across Scotland.

Ms Sturgeon said:

“It’s important that we have adequate provision of ECMO across the UK. Evidence gathered by the expert group will help us reach decisions about increasing ECMO capacity in Scotland.

“However, it will take time to establish dedicated Scottish provision. Therefore I and Health Ministers across the UK have asked the UK Critical Care Group to advise us on what action requires to be taken in the short term to increase UK capacity to deal with the flu pandemic flu.”

ECMO provision costs in the region of around £100,000 per patient episode.

ECMO is used to treat respiratory or cardiac failure that is considered to have a reversible cause and is unresponsive to conventional intensive care procedures. In essence, ECMO takes over part of the body’s function to enable the heart and lungs to recover and heal.

ECMO is similar to a heart-lung bypass machine. The patient’s circulation is connected to an external pump and an artificial lung (oxygenator). A catheter placed in the right side of the heart carries blood to a pump, then to a membrane oxygenator, where exchange of oxygen and carbon dioxide takes place. The blood then passes through the tubing back to either the venous or arterial circulation. An anticoagulant is used to prevent the blood clotting.

Adults may receive ECMO for a variety of reasons including post cardiac surgery and the conditions that may cause Adult Respiratory Distress Syndrome (ARDS) for example sepsis. Common causes for ECMO treatment in neonates and children include meconium aspiration, cardiac and respiratory causes, infection, and congenital diaphragmatic hernia.

ECMO is a highly specialised technique demanding even higher levels of medical, nursing and technical/laboratory support than in Level 3 (ICU) facility. An ECMO service has to have access to a large range of skills including trained intensive care medical and nursing staff with specific expertise in ECMO, perfusionists, respiratory specialists, operating theatre support, laboratory services, physiotherapists and other physicians and surgeons as well as numerous other services.

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Friday, November 7, 2008

Information and the History of Congenital Diaphragmatic Hernia

History of Congenital Diaphragmatic Hernia

- Diaphragmatic Hernia was first described in 1575 by Pare' in reporting in 2 autopsies of adults who had acquired diaphragmatic hernias by trauma.

- In 1672, the first description of Congenital Diaphragmatic Hernia was reported by Lazarus Riverius during the autopsy of an adult male. Miraculously, this man lived 24 yrs with CDH in the 17th century.

- In 1701, Holt reported the first case of CDH in a child.

- In 1796, Morgagni discussed various types of diaphragmatic hernia, including the anterior CDH that bears his name.

- In 1827, Cooper described the symptoms, pathology and classification of CDH.

- 1834 Laennec was the first to suggest a laparotomy that could be used to withdraw intestine from the chest cavity.

- In 1847, Bowditch presented the first collected series of patients with diaphragmatic hernia in 1847 before the Boston Society for Medical Observation.

- In 1848, Bochdalek, described CDH that occurs posterolateral. This now bears his name.

- In 1888, the first recorded attempt of a laparotomy to reduce the hernia was made by Naumann.

- In 1902 the first reported successful operation of an infant born with CDH

- In 1946, Robert Gross reported the first successful repair of a CDH in a baby less than 24 hours old.

- In 1976, ECMO (Extracorporeal Membrane Oxygenation) was first used successfully in the treatment of persistent pulmonary hypertension.

- In 1976, doctors first used lambs to create a CDH, researching for the cause and best treatment of CDH.

- In 1989, Michael Harrison led the team at the UCSF in the first succesful open fetal surgery for CDH.

- In 1992, "Gentle Ventilation" of CDH first began at the University of Florida, led by David Kays

- In 1994, the first NIH sponsored clinical trial for fetal surgery was done at UCSF for the open repair of congenital diaphragmatic hernia

- In 1995, The CDH Study Group was formed with medical professionals from the around the world with a vested interest in CDH.

- In 1995, the first international organization for families and medical care providers of children born with Congenital Diaphragmatic Hernia was created. CHERUBS still leads the CDH community in providing support and works with the medical committee to provide information and research options.

- In 1996, first successful fetoscopic temporary tracheal occlusion for CDH was done at UCSF by Harrison and team.

- In 1997, CHERUBS published it's first Congenital Diaphragmatic Hernia Research Survey Results, tallying research data from families.

- In 1997, the first on-line information site for CDH was created by CHERUBS.

- In 2000, First NIH sponsored randomized controlled trial for fetal surgery was done at UCSF

- In 2000, the first international conference for families affected by CDH was held in Orlando.

- In 2007, the Association of Congenital Diaphragmatic Hernia Organizations (ACDHO) was formed.

- Also in 2007, the Official Congenital Diaphragmatic Hernia Awareness Ribbon was created by families of children born with CDH to help raise awareness and research of the birth defect.

- In 2007, the first on-line forum specificially for CDH was created

- In 2008, CHERUBS created the first web site dedicated solely to free access of information for research of CDH.

- Stonewall Jackson suffered from an unrepaired Diaphragmatic Hernia. Whether it was Congenital is not known.

- CDH occurs in 1 of every 2500 to 4000 babies, as reported in 2006 by The CDH Study Group. The survival rate is still 50%.

- The cause of Congenital Diaphragmatic Hernia is still not known but it has been associated with several genetic anomalies such as Fryns Syndrome, Cornelia deLange System, Trisomy 18, 21 and 22.

- Is has been suggested in some medical journals, but not proven, that thalidomide, quinine, phenmetrazine and nitrofen may cause CDH. A Vitamin A diet deficiency is known to cause CDH is lab rats.

- 20% of CDH pregnancies also are diagnosed with polyhydramnios, an over abundance of amniotic fluid


In CHERUBS Membership:

- CDH has both occurred and not occurred in identical twins.

- We have many set of fraternal twins with one baby with CDH and the other healthy

- 3 families out of 2500 have had 3 children each with CDH. The reoccurance rate of CDH in siblings, without any other birth defects or genetic anomalies is 2%

- Our oldest living survivor of CDH is 62 years old. We have over 100 survivors over 18 yrs old.

- 3 of our members, all male, have had 6 CDH repairs each.

- CDH has been diagnosed in utero as early as 10 weeks for several of our members.

- Many of our adult survivors have gone on to have healthy babies and pregnancies of their own. Only 2 families have both a parent and a child born with CDH.

- Several of our members were diagnosed with CDH after 2 yrs old, with the oldest over 40 yrs old.