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Extracorporeal life support in pediatric burn care: A systematic review

Marc O Maybauer1,2,3, Dirk M Maybauer1,2, Massimo Capoccia4

  • 1Department of Anaesthesiology and Intensive Care, Philipps University, Marburg, Germany.

The International Journal of Artificial Organs
|February 21, 2023
PubMed

Insights

Extracorporeal life support (ECLS) offers significant benefits for pediatric patients with severe burn and smoke inhalation injuries. Early initiation of ECLS, particularly venovenous (VV) ECLS, is crucial for improving survival rates.

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiopulmonary Support
  • Burn Injury Management

Background:

  • Burn and smoke inhalation injuries pose significant challenges in pediatric critical care.
  • Extracorporeal life support (ECLS) is an emerging treatment option for severe cases.
  • Limited evidence exists on ECLS effectiveness in pediatric burn patients.

Approach:

  • A systematic review was conducted following PRISMA guidelines.
  • Literature search identified 14 relevant studies out of 266.
  • PICOS approach guided the analysis of pediatric patient data.

Key Points:

  • Extracorporeal membrane oxygenation (ECMO) provides crucial support for pediatric burn and smoke inhalation patients.
  • Venovenous (VV) ECMO configuration showed the highest survival rates, comparable to non-burned patients.
  • Delayed initiation of ECMO (prolonged mechanical ventilation) significantly decreases survival and increases mortality.

Conclusions:

  • ECLS is a valuable therapeutic option for pediatric patients with severe burn and smoke inhalation injuries.
  • Timely initiation of VV ECMO is associated with positive outcomes.
  • Further research is needed to optimize ECLS strategies in this population.

Keywords:
Burn injuryECLSECMOextracorporeal membrane oxygenationinhalation injurypediatric

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