Complication accrual impacts pediatric extracorporeal life support mortality.
Pediatr Surg Int
; 38(7): 985-991, 2022 Jul.
Article
in En
| MEDLINE
| ID: mdl-35596085
ABSTRACT
INTRODUCTION:
This study tested the hypothesis that complication accrual during pediatric extracorporeal life support (ECLS) increases mortality irrespective of indication for support.METHODS:
Prospectively collected Extracorporeal Life Support Organization (ELSO) registry data for all neonatal and pediatric patients cannulated for ECLS at our institution from 1/1/2015 to 12/31/2020 was stratified based on the presence or absence of complications. We excluded renal replacement therapy from complications, as this is frequently and empirically applied within our practice.RESULTS:
Of 114 patients, overall survival to discharge was 66%. 62 patients (54%) had 149 total complications 29% were mechanical (circuit related), and the rest were patient related. Age (neonatal versus pediatric), sex, race/ethnicity, support type, presence of pre-ECLS arrest, pre-ECLS pH and intubation-to-ECLS duration were not significantly associated with the development of complications. Patients with complications required longer ECLS duration (168 versus 86 median hours, p < 0.001) and were more likely to be decannulated due to death or poor prognosis (25% versus 8%, p = 0.022). One or more ECLS complications was associated with significantly decreased survival by Cox proportional hazard regression (p = 0.003).CONCLUSION:
Complications on ECLS are associated with longer support duration and predict decreased survival independent of pre-ECLS variables, suggesting a multidisciplinary ECLS team target for improved outcomes.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Extracorporeal Membrane Oxygenation
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child
/
Humans
/
Newborn
Language:
En
Journal:
Pediatr Surg Int
Journal subject:
PEDIATRIA
Year:
2022
Document type:
Article
Affiliation country:
United States