Related Experiment Video
Updated: Dec 26, 2025
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Extracorporeal Membrane Oxygenation Support for Pediatric Burn Patients: Is It Worth the Risk?
Kelly B Thompson1, Fakhry Dawoud2, Shannon Castle3
1Department of Pediatrics, Vanderbilt University School of Medicine, Nashville, TN.
Insights
Extracorporeal membrane oxygenation (ECMO) shows promise for pediatric burn patients, particularly those with respiratory failure, offering a survival rate of 55.7%. Further research is needed to optimize its use in this population.
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.
Objectives:
Examine the outcomes of pediatric burn patients requiring extracorporeal membrane oxygenation to determine whether extracorporeal membrane oxygenation should be considered in this special population.
Design:
Retrospective cohort study.
Setting:
All extracorporeal membrane oxygenation centers reporting to the Extracorporeal Life Support Organization.
Subjects:
Pediatric patients (birth to younger than 18 yr) who were supported with extracorporeal membrane oxygenation with a burn diagnosis between 1990 and 2016.
Interventions:
None.
Measurements And Main Results:
A total of 113 patients were identified from the registry by inclusion criteria. Patients cannulated for respiratory failure had the highest survival (55.7%, n = 97) compared to those supported for cardiac failure (33.3%, n = 6) or extracorporeal cardiopulmonary resuscitation (30%, n = 10). Patients supported on venovenous extracorporeal membrane oxygenation for respiratory failure had the best overall survival at 62.2% (n = 37). Important for the burn population, rates of surgical site bleeding were similar to other surgical patients placed on extracorporeal membrane oxygenation at 22.1%. Cardiac arrest prior to cannulation was associated with increased hospital mortality (odds ratio, 3.41; 95% CI, 0.16-1.01; p = 0.048). Following cannulation, complications including the need for inotropes (odds ratio, 2.64; 95% CI, 1.24-5.65; p = 0.011), presence of gastrointestinal hemorrhage (p = 0.049), and hyperglycemia (glucose > 240 mg/dL) (odds ratio, 3.42; 95% CI, 1.13-10.38; p = 0.024) were associated with increased mortality. Of patients with documented burn percentage of total body surface area (n = 19), survival was 70% when less than 60% total body surface area was involved.
Conclusions:
Extracorporeal membrane oxygenation could be considered as an additional level of support for the pediatric burn population, especially in the setting of respiratory failure. Additional studies are necessary to determine the optimal timing of cannulation and other patient characteristics that may impact outcomes.
More Related Videos
09:54Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
02:49Author Spotlight: A Multi-Depth Porcine Model for Comprehensive Study of Burn Injuries and Healing Processes
Published on: February 23, 2024
Related Concept Videos
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...
01:19Respiratory Assessment: Purpose and Indications
Objectives and Importance:
The primary goal of respiratory assessment is to evaluate patients at early risk of clinical deterioration. Since respiratory distress often precedes other signs of declining health, breathing patterns and sounds become a...
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:30Administering Oxygen by Mask
Administering oxygen by mask is a common nursing intervention that provides supplemental oxygen to patients with respiratory distress or chronic lung conditions. This procedure involves delivering oxygen at a specified rate through a face mask connected to an oxygen source.
Equipment
The equipment necessary for this procedure includes:
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:23Acute Respiratory Failure-IV