PURPOSE: The aim of the study is to test the effect of age and preextracorporeal membrane oxygenation (pre-ECMO) days of ventilation on ECMO survival in the pediatric population. METHODS: Retrospective analysis of noncardiac, pediatric (age >30 days) ECMO patients for the period January 1984 to June 2006. Pre-ECMO demographic, ventilatory, and lung injury severity variables were modeled with stepwise logistic regression to estimate survival probabilities associated with pre-ECMO ventilation duration and patient age. Patients were excluded from review for the following: pre-ECMO cardiac arrest, pre-ECMO ventilation of more than 30 days (chronic), or multiple runs on ECMO. RESULTS: For the period of review, 2550 patients met inclusion/exclusion criteria. The population had a mean age of 3.6 +/- 5.1 years (median age, 1 year). The mean pre-ECMO days of ventilation were 5.2 +/- 4.9 (median, 4 days). The overall survival probability was 58.6%. The mean oxygen index and Pao(2)/Fio(2) ratio were 62.2 +/- 48.2 and 95.5 +/- 48.2, respectively. The population overall demonstrated a statistically significant, exponential decline in survival as pre-ECMO days of ventilation increased (P < .05). For each additional year of age, survival decreased by an average of 2.5%. For each additional day of pre-ECMO ventilation, survival decreased by an average of 2.9%. Younger ages were generally associated with higher survival probabilities at each ventilation day. CONCLUSIONS: In the pediatric population, survival decreases significantly as pre-ECMO ventilator days increase. Survival is also inversely related to patient age. Thus, patient age and duration of ventilation should be considered when evaluating suitability for ECMO.
PURPOSE: The aim of the study is to test the effect of age and preextracorporeal membrane oxygenation (pre-ECMO) days of ventilation on ECMO survival in the pediatric population. METHODS: Retrospective analysis of noncardiac, pediatric (age >30 days) ECMO patients for the period January 1984 to June 2006. Pre-ECMO demographic, ventilatory, and lung injury severity variables were modeled with stepwise logistic regression to estimate survival probabilities associated with pre-ECMO ventilation duration and patient age. Patients were excluded from review for the following: pre-ECMO cardiac arrest, pre-ECMO ventilation of more than 30 days (chronic), or multiple runs on ECMO. RESULTS: For the period of review, 2550 patients met inclusion/exclusion criteria. The population had a mean age of 3.6 +/- 5.1 years (median age, 1 year). The mean pre-ECMO days of ventilation were 5.2 +/- 4.9 (median, 4 days). The overall survival probability was 58.6%. The mean oxygen index and Pao(2)/Fio(2) ratio were 62.2 +/- 48.2 and 95.5 +/- 48.2, respectively. The population overall demonstrated a statistically significant, exponential decline in survival as pre-ECMO days of ventilation increased (P < .05). For each additional year of age, survival decreased by an average of 2.5%. For each additional day of pre-ECMO ventilation, survival decreased by an average of 2.9%. Younger ages were generally associated with higher survival probabilities at each ventilation day. CONCLUSIONS: In the pediatric population, survival decreases significantly as pre-ECMO ventilator days increase. Survival is also inversely related to patient age. Thus, patient age and duration of ventilation should be considered when evaluating suitability for ECMO.
Authors: Michael R Phillips; Amal L Khoury; Briana J K Stephenson; Lloyd J Edwards; Anthony G Charles; Sean E McLean Journal: Am Surg Date: 2015-03 Impact factor: 0.688
Authors: David K Bailly; Ron W Reeder; Luke A Zabrocki; Anna M Hubbard; Jacob Wilkes; Susan L Bratton; Ravi R Thiagarajan Journal: Crit Care Med Date: 2017-01 Impact factor: 7.598
Authors: David K Bailly; Jamie M Furlong-Dillard; Melissa Winder; Mark Lavering; Ryan P Barbaro; Kathleen L Meert; Susan L Bratton; Heidi Dalton; Ron W Reeder Journal: Perfusion Date: 2020-08-29 Impact factor: 1.972
Authors: Christopher S Parshuram; Karen Dryden-Palmer; Catherine Farrell; Ronald Gottesman; Martin Gray; James S Hutchison; Mark Helfaer; Elizabeth Hunt; Ari Joffe; Jacques Lacroix; Vinay Nadkarni; Patricia Parkin; David Wensley; Andrew R Willan Journal: Trials Date: 2015-06-02 Impact factor: 2.279
Authors: David K Bailly; Ron W Reeder; Melissa Winder; Ryan P Barbaro; Murray M Pollack; Frank W Moler; Kathleen L Meert; Robert A Berg; Joseph Carcillo; Athena F Zuppa; Christopher Newth; John Berger; Michael J Bell; Michael J Dean; Carol Nicholson; Pamela Garcia-Filion; David Wessel; Sabrina Heidemann; Allan Doctor; Rick Harrison; Susan L Bratton; Heidi Dalton Journal: Pediatr Crit Care Med Date: 2019-05 Impact factor: 3.624