Outcomes of extracorporeal life support for respiratory failure in children with primary immunodeficiencies
OBJECTIVE: Extracorporeal Membrane Oxygenation (ECMO) may serve as a life-saving rescue therapy in critically ill children with respiratory failure. While survival rates of ECMO in children with secondary immunodeficiency is considered relatively poor, survival rates in children with primary immunodeficiencies (PID) has yet to be thoroughly investigated.
DESIGN: Retrospective analysis of prospectively collected data from children (29 days-18 years old). PID patients were identified by using International Classification of Diseases (ICD) codes.
SETTING: Data were retrieved from Extracorporeal Life Support Organization Registry (1989-2018).
INTERVENTIONS: ECMO for a pulmonary support indication. The survival-to-discharge rate was calculated and factors influencing outcomes were compared between survivors and non-survivors.
MEASUREMENTS AND MAIN RESULTS: A total of 73 eligible ECMO runs were included. The survival-to-discharge rate in pediatric PID patients was 45.2%. No differences were noted in survival based on type of immunodeficiency (p = 0.42) or decade of support (p = 0.98). There was no difference in the rate of pre-ECMO infection in survivors versus non-survivors (p = 0.69). The survival-to-discharge rate in patients with a culture positive infection during the ECMO run was 45.0% versus 45.3% in those with no infection (p = 0.98). In multivariate analysis, only cardiac complications (OR 5.09, 95% CI: 1.15-22.53), pulmonary complications (OR: 13.00, 95% CI: 1.20-141.25), and neurologic complications (OR: 9.86, 95% CI: 1.64-59.21) were independently associated with increased mortality.
CONCLUSION: Children with a PID who require extracorporeal life support due to respiratory failure have a reasonable chance of survival and should be considered candidates for ECMO. The presence of a pre-ECMO infection should not be considered an ECMO contraindication.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2023 |
|---|---|
| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:38 |
|---|---|
| Enthalten in: |
Perfusion - 38(2023), 1 vom: 03. Jan., Seite 37-43 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Henry, Brandon Michael [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Children |
|---|
| Anmerkungen: |
Date Completed 16.01.2023 Date Revised 23.01.2023 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1177/02676591211033946 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM328242349 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM328242349 | ||
| 003 | DE-627 | ||
| 005 | 20231225202538.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2023 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1177/02676591211033946 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1094.xml |
| 035 | |a (DE-627)NLM328242349 | ||
| 035 | |a (NLM)34278883 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Henry, Brandon Michael |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Outcomes of extracorporeal life support for respiratory failure in children with primary immunodeficiencies |
| 264 | 1 | |c 2023 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 16.01.2023 | ||
| 500 | |a Date Revised 23.01.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE: Extracorporeal Membrane Oxygenation (ECMO) may serve as a life-saving rescue therapy in critically ill children with respiratory failure. While survival rates of ECMO in children with secondary immunodeficiency is considered relatively poor, survival rates in children with primary immunodeficiencies (PID) has yet to be thoroughly investigated | ||
| 520 | |a DESIGN: Retrospective analysis of prospectively collected data from children (29 days-18 years old). PID patients were identified by using International Classification of Diseases (ICD) codes | ||
| 520 | |a SETTING: Data were retrieved from Extracorporeal Life Support Organization Registry (1989-2018) | ||
| 520 | |a INTERVENTIONS: ECMO for a pulmonary support indication. The survival-to-discharge rate was calculated and factors influencing outcomes were compared between survivors and non-survivors | ||
| 520 | |a MEASUREMENTS AND MAIN RESULTS: A total of 73 eligible ECMO runs were included. The survival-to-discharge rate in pediatric PID patients was 45.2%. No differences were noted in survival based on type of immunodeficiency (p = 0.42) or decade of support (p = 0.98). There was no difference in the rate of pre-ECMO infection in survivors versus non-survivors (p = 0.69). The survival-to-discharge rate in patients with a culture positive infection during the ECMO run was 45.0% versus 45.3% in those with no infection (p = 0.98). In multivariate analysis, only cardiac complications (OR 5.09, 95% CI: 1.15-22.53), pulmonary complications (OR: 13.00, 95% CI: 1.20-141.25), and neurologic complications (OR: 9.86, 95% CI: 1.64-59.21) were independently associated with increased mortality | ||
| 520 | |a CONCLUSION: Children with a PID who require extracorporeal life support due to respiratory failure have a reasonable chance of survival and should be considered candidates for ECMO. The presence of a pre-ECMO infection should not be considered an ECMO contraindication | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a children | |
| 650 | 4 | |a extracorporeal life support | |
| 650 | 4 | |a immunodeficiency | |
| 650 | 4 | |a outcomes | |
| 650 | 4 | |a pediatrics | |
| 700 | 1 | |a Benscoter, Alexis L |e verfasserin |4 aut | |
| 700 | 1 | |a de Oliveira, Maria Helena Santos |e verfasserin |4 aut | |
| 700 | 1 | |a Vikse, Jens |e verfasserin |4 aut | |
| 700 | 1 | |a Perry, Tanya |e verfasserin |4 aut | |
| 700 | 1 | |a Cooper, David S |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t Perfusion |d 1990 |g 38(2023), 1 vom: 03. Jan., Seite 37-43 |w (DE-627)NLM074653768 |x 1477-111X |7 nnns |
| 773 | 1 | 8 | |g volume:38 |g year:2023 |g number:1 |g day:03 |g month:01 |g pages:37-43 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1177/02676591211033946 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 38 |j 2023 |e 1 |b 03 |c 01 |h 37-43 | ||