Extracorporeal membranous oxygenation (ecmo) in children – 12 years experience
Abstract
Background: Extracorporeal membranous oxigenation (ECMO) is an established treatment of children with severe yet amenable lung or heart failure.
Methods: Retrospective analysis of 12 years of experience (1994–2005) includes: a) ECMO treatment type, b) selection and status of children upon connection, c) percentage and quality of survival, d) influence of pre-ECMO risk factors on survival, and e) complications.
Results: ECMO was applied in 18 children: veno-venous type in 6 (33%), veno-arterial in 12 (66%) children. All children had deep hipoxy and 80% probability of dying. There were 12 boys (66%) and 6 girls (34%). The majority were newborns – there were 12 (66%) while the other 6 children (34%) were aged 2 to 24 months. Average duration of ECMO in newborns was 131 hours (SD 83; range 27–288), and in older children 253 hours (151; 45–434). Average birth weight of newborns was 3190 g (654; 2320–4360), average gestation age 38.5 weeks (2.2; 34–41). Of the 18 children treated with ECMO, 11 survived (61%), while 4 died subsequently. Observed 24 hours after ECMO survival rate was higher in newborns (67%) than in older children (50%), but the difference was not statistically significant (p = 0.627). Up to the present, 7 of the 11 have survived, five reached normal mental and physical development at final check-up, one has moderate motor disturbances with behavioural disorders, one has severe disability. It can be inferred that in addition to oxygenation index, plasma HCO3 level, mean arterial blood pressure and mean airway pressure before ECMO treatment are potential prognostic factors for newborn survival.
Conclusions: The results of ECMO treatment justify the use and continuation of the ECMO programme in Slovenia.
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References
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