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Survival of Children With Pulmonary Embolism Supported by Extracorporeal Membrane Oxygenation

John S Kim1, Cindy S Barrett1, Robert W Hyslop2

  • 1Department of Pediatrics, Heart Institute, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, United States.

Frontiers in Pediatrics
|May 20, 2022
PubMed

Insights

Extracorporeal Membrane Oxygenation (ECMO) for pediatric pulmonary embolism is associated with significant survival, though pulmonary bleeding complications were more common in non-survivors. Demographics and ECMO parameters did not differ between survivors and non-survivors.

Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary support technologies
  • Pediatric cardiology and pulmonology

Background:

  • Pulmonary embolism (PE) in children is a rare but serious condition.
  • Extracorporeal Membrane Oxygenation (ECMO) offers life support for severe pediatric PE.
  • Limited data exists on outcomes for pediatric PE patients requiring ECMO.

Purpose of the Study:

  • To describe the demographics and in-hospital mortality of children (<18 years) treated with ECMO for PE.
  • To identify factors associated with survival in this pediatric population.
  • To analyze ECMO-related complications in pediatric PE patients.

Main Methods:

  • Retrospective analysis of pediatric patients (<18 years) diagnosed with PE and supported by ECMO.
  • Data sourced from the Extracorporeal Life Support Organization (ELSO) registry from 2007 to 2018.
  • Comparison of demographics, ECMO characteristics, and complication rates between survivors and non-survivors.

Main Results:

  • Fifty-six pediatric patients with PE supported by ECMO were identified; 54 were analyzed.
  • Overall in-hospital survival rate was 61% (33 out of 54 patients).
  • Pulmonary bleeding occurred significantly more often in non-survivors (23.8%) than survivors (0%, p=0.006).
  • No significant differences were observed in patient demographics or ECMO parameters (duration, mode, support type) between survivors and non-survivors.

Conclusions:

  • Pediatric patients with PE requiring ECMO have a considerable survival rate.
  • Pulmonary bleeding is a critical complication associated with higher mortality in this cohort.
  • Further research into optimizing ECMO management and reducing bleeding complications is warranted.

Keywords:
ECMO - extracorporeal membrane oxygenationchildrendatabasepulmonary embloismsurvival

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