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rescue therapy was chosen or when the patient was escalated from IVA to ECMO without a clear guideline or standardized method for escalation to rescue therapy at our institution .
Conclusion
The use of ECMO and IVA for patients with SA varies significantly among institutions based on medical team variation in decision . While we cannot decisively draw any conclusions from our small study , there does not seem to be a clear advantage of using IVA as therapy prior to escalation of this patient population to ECMO . Given the high cost and potential complications of both rescue therapies , there is a need for more prospective trials and development of well-defined guidelines for severe SA management in the pediatric ICU setting .
Funding
This project was done without any internal or external funding support .
Conflicts of interest
The authors have no financial relationships or conflicts of interest relevant to this article to disclose .
Data availability statement All available data are incorporated into the article .
Author contribution statement
Kavipriya Komeswaran and Jamie Furlong Dillard designed the study , performed the research and analyzed the data . Jamie Furlong Dillard , Deanna Todd Tzanetos and Tiffany Wright provided expertise in clinical data analysis . Kavipriya Komeswaran wrote the manuscript , and all authors contributed to the final version .
Ethics approval
Data Collection was conducted as a retrospective cohort study . The study protocol was approved by the institution ethics committee of the University of Louisville , Kentucky . Medical research is subject to ethical standards that promote and ensure respect for all human subjects and protect their health and rights .
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