Extracorporeal Life Support Registry Report 2008: neonatal and pediatric cardiac cases

Each year thousands of patients require extracorporeal life support (ECLS) for a variety of respiratory, cardiac, and emergency reasons. The ECLS registry, a Federal Drug Administration approved control group, provides a database of approximately 37,000 ECLS patients from domestic and international hospitals, with details about demographic factors, diagnosis, treatment, and complications. The report is circulated to Extracorporeal Life Support Organization members with the goal of providing feedback on each center's practices relative to the performance of all of the centers, and to the general public with the goal of enhancing research and improving patient care. In this report, the ECLS Registry Report International Summary for July 2008 is analyzed with a specific focus on neonatal and pediatric cardiac patients. From the data, it is evident that cardiac ECLS patients have a lower chance of survival than respiratory ECLS patients, and furthermore, younger patients have a lower chance of survival. Requirement for inotropes while on ECLS is by far the most common complication, followed by surgical site bleeding, necessitating hemofiltration. The major mechanical complications facing cardiac ECLS patients are oxygenator failure and clots in the circuit. Databases such as this one provide powerful tools for institutions, clinicians, and researchers.