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Published on: October 24, 2018

Airway complications of pediatric extracorporeal membrane oxygenation

Nicholas J M Agar1, Robert G Berkowitz

  • 1Department of Otolaryngology, Royal Children's Hospital, Melbourne, Australia.

The Annals of Otology, Rhinology, and Laryngology
|July 22, 2011
PubMed

Insights

Children needing extracorporeal membrane oxygenation (ECMO) have a low incidence of laryngotracheal stenosis. This study found the rate of airway stenosis in pediatric ECMO survivors to be acceptably low, suggesting ECMO is safe for pediatric patients.

Area of Science:

  • Pediatric critical care medicine
  • Otolaryngology
  • Thoracic surgery

Background:

  • Prolonged intubation is a known risk factor for laryngotracheal stenosis.
  • Children requiring extracorporeal membrane oxygenation (ECMO) often have extended intubation periods.
  • The risk of laryngotracheal stenosis in pediatric ECMO patients is not well-defined.

Purpose of the Study:

  • To determine the incidence of laryngotracheal stenosis in children undergoing ECMO.
  • To assess the rate of tracheostomy in pediatric ECMO patients.
  • To evaluate the association between ECMO and airway complications.

Main Methods:

  • A retrospective review of pediatric patients (<18 years) who underwent ECMO from July 2009.
  • Identification of patients requiring surgical airway procedures from the extracorporeal life support database.
  • Analysis of airway stenosis and tracheostomy rates in ECMO patients.

Main Results:

  • Overall survival rate was 51.4% among 218 ECMO patients.
  • 14 patients (6.4%) required surgical airway procedures; 11 (5.0%) needed tracheostomy.
  • Clinically significant laryngotracheal stenosis occurred in 3 patients (2.7% of survivors).

Conclusions:

  • The incidence of laryngotracheal stenosis in children requiring ECMO is acceptably low.
  • ECMO does not appear to significantly increase the risk of airway stenosis in pediatric survivors.
  • Further research may explore specific risk factors for stenosis in this population.
Abstract

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