Results of extracorporeal membrane oxygenation in children with sepsis

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Abstract

Background. Despite good results in neonates, extracorporeal membrane oxygenation (ECMO) is less well accepted in pediatric patients. Older children frequently undergo ECMO for severe bacterial, viral, or aspiration pneumonia and many have coexisting systemic sepsis. We reviewed data from a national registry to study the influence of sepsis on survival from ECMO. Methods. Six hundred fifty-five patients (aged 2 weeks to 17 years) with respiratory failure treated with ECMO were divided into two groups by the presence (n = 76) or absence (n = 579) of sepsis. Groups were compared by univariate analysis and by multivariate logistic regression that considered 10 additional pre-ECMO variables (age, sex, weight, arterial blood gas results, ventilator parameters, and renal failure). Results. By univariate analysis, survival was lower in septic children (36.8% versus 51.6%; p < 0.02). However, by multivariate analysis, sepsis was not an independent survival predictor (odds ratio, 0.578; 95% confidence interval, 0.288-1.162; p = 0.12). The ECMO complications predicted by the presence of sepsis included (1) seizures, (2) other neurologic complications, and (3) infection at other sites (all p < 0.05). Conclusions. Systemic sepsis does not independently influence survival in pediatric ECMO. This therapy should not be withheld solely because of sepsis, although neurologic complications may occur more frequently.

Original languageEnglish (US)
Pages (from-to)756-761
Number of pages6
JournalAnnals of Thoracic Surgery
Volume63
Issue number3
DOIs
StatePublished - Mar 1997

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Extracorporeal Membrane Oxygenation
Sepsis
Survival
Nervous System
Multivariate Analysis
Viral Pneumonia
Pediatrics
Bacterial Pneumonia
Aspiration Pneumonia
Mechanical Ventilators
Respiratory Insufficiency
Renal Insufficiency
Registries
Seizures
Gases
Logistic Models
Odds Ratio
Newborn Infant
Confidence Intervals
Weights and Measures

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Results of extracorporeal membrane oxygenation in children with sepsis. / Meyer, Dan M; Jessen, Michael E.

In: Annals of Thoracic Surgery, Vol. 63, No. 3, 03.1997, p. 756-761.

Research output: Contribution to journalArticle

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abstract = "Background. Despite good results in neonates, extracorporeal membrane oxygenation (ECMO) is less well accepted in pediatric patients. Older children frequently undergo ECMO for severe bacterial, viral, or aspiration pneumonia and many have coexisting systemic sepsis. We reviewed data from a national registry to study the influence of sepsis on survival from ECMO. Methods. Six hundred fifty-five patients (aged 2 weeks to 17 years) with respiratory failure treated with ECMO were divided into two groups by the presence (n = 76) or absence (n = 579) of sepsis. Groups were compared by univariate analysis and by multivariate logistic regression that considered 10 additional pre-ECMO variables (age, sex, weight, arterial blood gas results, ventilator parameters, and renal failure). Results. By univariate analysis, survival was lower in septic children (36.8{\%} versus 51.6{\%}; p < 0.02). However, by multivariate analysis, sepsis was not an independent survival predictor (odds ratio, 0.578; 95{\%} confidence interval, 0.288-1.162; p = 0.12). The ECMO complications predicted by the presence of sepsis included (1) seizures, (2) other neurologic complications, and (3) infection at other sites (all p < 0.05). Conclusions. Systemic sepsis does not independently influence survival in pediatric ECMO. This therapy should not be withheld solely because of sepsis, although neurologic complications may occur more frequently.",
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AU - Jessen, Michael E

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N2 - Background. Despite good results in neonates, extracorporeal membrane oxygenation (ECMO) is less well accepted in pediatric patients. Older children frequently undergo ECMO for severe bacterial, viral, or aspiration pneumonia and many have coexisting systemic sepsis. We reviewed data from a national registry to study the influence of sepsis on survival from ECMO. Methods. Six hundred fifty-five patients (aged 2 weeks to 17 years) with respiratory failure treated with ECMO were divided into two groups by the presence (n = 76) or absence (n = 579) of sepsis. Groups were compared by univariate analysis and by multivariate logistic regression that considered 10 additional pre-ECMO variables (age, sex, weight, arterial blood gas results, ventilator parameters, and renal failure). Results. By univariate analysis, survival was lower in septic children (36.8% versus 51.6%; p < 0.02). However, by multivariate analysis, sepsis was not an independent survival predictor (odds ratio, 0.578; 95% confidence interval, 0.288-1.162; p = 0.12). The ECMO complications predicted by the presence of sepsis included (1) seizures, (2) other neurologic complications, and (3) infection at other sites (all p < 0.05). Conclusions. Systemic sepsis does not independently influence survival in pediatric ECMO. This therapy should not be withheld solely because of sepsis, although neurologic complications may occur more frequently.

AB - Background. Despite good results in neonates, extracorporeal membrane oxygenation (ECMO) is less well accepted in pediatric patients. Older children frequently undergo ECMO for severe bacterial, viral, or aspiration pneumonia and many have coexisting systemic sepsis. We reviewed data from a national registry to study the influence of sepsis on survival from ECMO. Methods. Six hundred fifty-five patients (aged 2 weeks to 17 years) with respiratory failure treated with ECMO were divided into two groups by the presence (n = 76) or absence (n = 579) of sepsis. Groups were compared by univariate analysis and by multivariate logistic regression that considered 10 additional pre-ECMO variables (age, sex, weight, arterial blood gas results, ventilator parameters, and renal failure). Results. By univariate analysis, survival was lower in septic children (36.8% versus 51.6%; p < 0.02). However, by multivariate analysis, sepsis was not an independent survival predictor (odds ratio, 0.578; 95% confidence interval, 0.288-1.162; p = 0.12). The ECMO complications predicted by the presence of sepsis included (1) seizures, (2) other neurologic complications, and (3) infection at other sites (all p < 0.05). Conclusions. Systemic sepsis does not independently influence survival in pediatric ECMO. This therapy should not be withheld solely because of sepsis, although neurologic complications may occur more frequently.

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