Extracorporeal membrane oxygenation for pediatric respiratory failure: Survival and predictors of mortality*
- 1 February 2011
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Critical Care Medicine
- Vol. 39 (2), 364-370
- https://doi.org/10.1097/ccm.0b013e3181fb7b35
Abstract
The last multicentered analysis of extracorporeal membrane oxygenation in pediatric acute respiratory failure was completed in 1993. We reviewed recent international data to evaluate survival and predictors of mortality. Retrospective case series review. The Extracorporeal Life Support Organization Registry, which includes data voluntarily submitted from over 115 centers worldwide, was queried. The work was completed at the Division of Pediatric Critical Care, Department of Pediatrics, Primary Children's Medical Center, University of Utah, Salt Lake City, UT. Patients aged 1 month to 18 yrs supported with extracorporeal membrane oxygenation for acute respiratory failure from 1993 to 2007. None. There were 3,213 children studied. Overall survival remained relatively unchanged over time at 57%. Considerable variability in survival was found based on pulmonary diagnosis, ranging from 83% for status asthmaticus to 39% for pertussis. Comorbidities significantly decreased survival to 33% for those with renal failure (n = 329), 16% with liver failure (n = 51), and 5% with hematopoietic stem cell transplantation (n = 22). The proportion of patients with comorbidities increased from 19% during 1993 to 47% in 2007. Clinical factors associated with mortality included precannulation ventilatory support longer than 2 wks and lower precannulation blood pH. Although the survival of pediatric patients with acute respiratory failure treated with extracorporeal membrane oxygenation has not changed, this treatment is currently offered to increasingly medically complex patients. Mechanical ventilation in excess of 2 wks before the initiation of extracorporeal membrane oxygenation is associated with decreased survival.Keywords
This publication has 32 references indexed in Scilit:
- Extracorporeal membrane oxygenation as a rescue therapy for leukaemic children with pulmonary failureBritish Journal of Haematology, 2010
- Efficacy and economic assessment of conventional ventilatory support versus extracorporeal membrane oxygenation for severe adult respiratory failure (CESAR): a multicentre randomised controlled trialThe Lancet, 2009
- Extracorporeal life support for support of children with malignancy and respiratory or cardiac failure: The extracorporeal life support experience*Critical Care Medicine, 2009
- Extracorporeal life support for severe respiratory failure in children with immune compromised conditions*Pediatric Critical Care Medicine, 2008
- Ventilation with Lower Tidal Volumes as Compared with Traditional Tidal Volumes for Acute Lung Injury and the Acute Respiratory Distress SyndromeNew England Journal of Medicine, 2000
- Venovenous versus venoarterial extracorporeal life support for pediatric respiratory failure: Are there differences in survival and acute complications?Critical Care Medicine, 2000
- Mortality is directly related to the duration of mechanical ventilation before the initiation of extracorporeal life support for severe respiratory failureCritical Care Medicine, 1997
- Extracorporeal life support for pediatric respiratory failureCritical Care Medicine, 1993
- Predictors of outcome of severe respiratory syncytial virus-associated respiratory failure treated with extracorporeal membrane oxygenationThe Journal of Pediatrics, 1993
- Extracorporeal life support for pediatric respiratory failureCritical Care Medicine, 1992