Outcomes of pediatric patients with abdominal sepsis requiring surgery and extracorporeal membrane oxygenation using the Extracorporeal Life Support Organization database

Area of Science:

• Pediatric Critical Care Medicine
• Surgical Critical Care
• Extracorporeal Life Support

Background:

• Extracorporeal membrane oxygenation (ECMO) is a vital support for critically ill patients.
• Limited data exists on ECMO use in pediatric patients with abdominal sepsis (AS) requiring surgery.
• Understanding outcomes is crucial for clinical decision-making and family counseling.

Purpose of the Study:

• To describe outcomes of pediatric patients with AS requiring surgery who underwent ECMO.
• To identify factors associated with mortality in this specific patient cohort.

Main Methods:

• Retrospective analysis of the Extracorporeal Life Support Organization (ELSO) database.
• Inclusion criteria: pediatric patients (30 days to 18 years) with AS requiring surgery.
• Comparison of characteristics and outcomes between survivors and non-survivors.

Main Results:

• Overall survival rate was 73.8% (45 out of 61 patients).
• Bleeding complications and pre-ECMO ventilator hours were similar between survivors and non-survivors.
• Decreased pre-ECMO mean pH (acidemia) was significantly associated with increased mortality (OR 1.49).

Conclusions:

• ECMO use in pediatric AS requiring surgery is associated with higher mortality and bleeding rates compared to general pediatric ECMO patients.
• Pre-ECMO acidemia is a significant predictor of mortality.
• Further research should focus on managing acidemia in this population.