Ventilation Parameters Before Extracorporeal Membrane Oxygenator and In-Hospital Mortality in Children: A Review of the ELSO Registry.
Journal
ASAIO journal (American Society for Artificial Internal Organs : 1992)
ISSN: 1538-943X
Titre abrégé: ASAIO J
Pays: United States
ID NLM: 9204109
Informations de publication
Date de publication:
01 02 2022
01 02 2022
Historique:
pubmed:
21
9
2021
medline:
2
2
2022
entrez:
20
9
2021
Statut:
ppublish
Résumé
The aim of this study was to evaluate the impact of pre-extracorporeal membrane oxygenation (ECMO) ventilatory parameters with in-hospital mortality in children with pediatric acute respiratory distress syndrome undergoing ECMO for respiratory indication. In this retrospective analysis of the Extracorporeal Life Support Organization (ELSO) Registry, all pediatric patients (≥29 days to ≤18 years) who required ECMO for respiratory indications were screened. The primary outcome was in-hospital mortality. From 2013 to 2017, 2,727 pediatric ECMO runs with a respiratory indication were reported to the ELSO registry. Overall mortality was 37%. Oxygenation Index (OI) and duration of mechanical ventilation (MV) before ECMO deployment were both independently associated with in-hospital mortality. No threshold effect for OI was observed. Pre-ECMO positive end-expiratory pressure and delta pressure levels were respectively lower and higher than recommended. Mortality rates for OI values between 4 and 60 and above oscillated between 32% and 45%. Children within a wider range of pre-ECMO OI (either below or above 40) might be considered as reasonable candidates for ECMO deployment. Larger, prospective multicenter studies to confirm the discriminatory ability of OI are warranted.
Identifiants
pubmed: 34542991
doi: 10.1097/MAT.0000000000001445
pii: 00002480-202202000-00022
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
281-286Informations de copyright
Copyright © ASAIO 2021.
Déclaration de conflit d'intérêts
R.B. discloses relationships with Extracorporeal Life Support Organization Registry as the Registry Chair and NHLBI, NIH K12 HL138039. The other authors report no conflict of interests.
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