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Severe Adenovirus Pneumonia Requiring Extracorporeal Membrane Oxygenation Support in Immunocompetent Children

Xuefei Chen1, Jianhai Lv2,3, Lu Qin2

  • 1Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, China.

Frontiers in Pediatrics
|May 1, 2020
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) may improve outcomes for immunocompetent children with severe adenovirus pneumonia and acute respiratory distress syndrome. Careful consideration of ECMO-related complications and sequelae is advised.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe adenovirus pneumonia can cause acute respiratory distress syndrome (ARDS) in immunocompetent children.
  • Extracorporeal membrane oxygenation (ECMO) is a potential life-saving therapy for pediatric ARDS.
  • Limited data exists on ECMO use in immunocompetent children with severe adenovirus pneumonia.

Purpose of the Study:

  • To analyze outcomes of severe adenovirus pneumonia requiring ECMO in immunocompetent pediatric patients.
  • To evaluate ECMO as a rescue ventilation strategy for severe adenovirus pneumonia.
  • To identify factors influencing outcomes in this patient population.

Main Methods:

  • Retrospective analysis of 8 pediatric patients with adenovirus pneumonia and ECMO support.
  • Comparison with 100 children with common adenovirus pneumonia as a control group.
  • Data collection on patient demographics, clinical course, ventilation, ECMO parameters, and outcomes.

Main Results:

  • Median age of enrolled patients was 31 months; all were previously immunocompetent.
  • Respiratory failure occurred after a median of 5 days of symptoms; ECMO was initiated after mechanical ventilation.
  • 75% of patients recovered, with a median ICU stay of 27.5 days; 25% mortality was observed.

Conclusions:

  • ECMO support may be a viable rescue ventilation option for deteriorating adenovirus pneumonia cases.
  • ECMO can potentially improve outcomes in severe adenovirus pneumonia with ARDS.
  • Sequelae and ECMO-related complications require careful management and consideration.

Keywords:
acute respiratory distress syndromeadenovirus pneumoniaextracorporeal membrane oxygenationrisk factorssurvival rate

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