Extracorporeal Membrane Oxygenation Support for Pediatric Burn Patients: Is It Worth the Risk?

Area of Science:

• Pediatric Critical Care Medicine
• Extracorporeal Life Support
• Burn Injury Management

Background:

• Pediatric burn patients often face severe respiratory and/or cardiac complications.
• Extracorporeal membrane oxygenation (ECMO) is a life support technology used for severe cases.
• The efficacy of ECMO in pediatric burn patients remains an area requiring further investigation.

Purpose of the Study:

• To evaluate the outcomes of pediatric burn patients treated with ECMO.
• To determine the potential role of ECMO as a therapeutic option for this specific patient group.

Main Methods:

• Retrospective cohort study analyzing data from ECMO centers.
• Inclusion criteria: pediatric patients (0-17 years) with burn diagnosis requiring ECMO support from 1990-2016.
• Data sourced from the Extracorporeal Life Support Organization (ELSO) registry.

Main Results:

• 113 pediatric burn patients were identified.
• Survival rates varied by indication: respiratory failure (55.7%), cardiac failure (33.3%), and extracorporeal cardiopulmonary resuscitation (30%).
• Venovenous ECMO for respiratory failure showed the highest survival (62.2%). Surgical site bleeding rates (22.1%) were comparable to other surgical ECMO patients. Pre-cannulation cardiac arrest and post-cannulation complications (inotropes, GI hemorrhage, hyperglycemia) were associated with increased mortality.

Conclusions:

• ECMO may be a viable support option for pediatric burn patients, especially those with respiratory failure.
• Further research is warranted to establish optimal cannulation timing and identify factors influencing outcomes.
• The study highlights the need for tailored ECMO strategies in severe pediatric burn cases.