Outcomes in pediatric extracorporeal cardiopulmonary resuscitation: A single-center retrospective study from 2007 to 2022 in China

• Published in: The American journal of emergency medicine Vol. 83; pp. 25 - 31
• Main Authors: Zhao, Wen-Ting, He, Wen-Long, Yang, Li-Jun, Lin, Ru
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024; Elsevier Limited
• Subjects: Bleeding; Cardiac arrest; Cardiac arrhythmia; Cardiopulmonary resuscitation; Complications; Congenital diseases; Contraindications; CPR; Extracorporeal cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Hemorrhage; Hospitals; Immune system; Immunodeficiency; Ischemia; Lifesaving; Mechanical ventilation; Medical prognosis; Missing data; Neonates; Neurological complications; Outcomes; Patients; Pediatric; Pediatrics; Regression analysis; Risk factors; Stroke; Survival; Thromboembolism; Thrombosis; Ventilation; Ventilators; United States > US; Complications; Pediatric; Survival; Risk factors; Outcomes; Extracorporeal cardiopulmonary resuscitation
• ISSN: 0735-6757; 1532-8171; 1532-8171
• DOI: 10.1016/j.ajem.2024.06.034

We aimed to investigate the prognostic factors of pediatric extracorporeal cardiopulmonary resuscitation (ECPR). The retrospective study included a total of 77 pediatric cases (7 neonates and 70 children) who underwent ECPR after in-hospital and out-of-hospital cardiac arrest between July 2007 and December 2022. Primary endpoints were complications, while secondary endpoints included all-cause in-hospital mortality. Among the 45 cases experiencing complications, 4 neonates and 41 children had multiple simultaneous complications, primarily neurological issues in 25 cases. Additionally, organ failure occurred in 11 cases, and immunodeficiency was present in two cases. Furthermore, 9 cases experienced bleeding events, and 13 cases showed thrombosis. Patients with complications had lower weight, shorter ECMO durations, and longer CPR durations. Non-survivors had longer CPR durations and shorter durations of ECMO, ICU stay, and mechanical ventilation compared to survivors. Complications were more prevalent in non-survivors, particularly organ failure and bleeding events. Weight, CPR duration, and ECMO duration were associated with complications, suggesting areas for treatment optimization. The higher occurrence of complications in non-survivors underscores the importance of early detection and management to improve survival rates. Our findings suggest clinicians consider these factors in prognostic assessments to enhance the effectiveness of ECPR programs.