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Hospital ECMO capability is associated with survival in pediatric cardiac arrest

Blythe E Pollack1, Ryan P Barbaro2, Stephen M Gorga1

  • 1Division of Critical Care Medicine, Department of Pediatrics, University of Michigan, United States.

Resuscitation
|May 28, 2023
PubMed

Insights

Hospitals with Extracorporeal Membrane Oxygenation (ECMO) capability showed higher survival rates for pediatric cardiac arrest patients. This suggests ECMO availability is linked to better outcomes in children experiencing cardiac arrest.

Area of Science:

  • Pediatric critical care medicine
  • Cardiovascular research
  • Health services research

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support technology for severe cardiac or respiratory failure.
  • Its impact on survival rates for pediatric cardiac arrest is not well understood.
  • Evaluating hospital ECMO capability is crucial for improving outcomes in critically ill children.

Purpose of the Study:

  • To determine if a hospital's Extracorporeal Membrane Oxygenation (ECMO) capability is associated with improved survival rates in children who suffer cardiac arrest.
  • To analyze the relationship between pediatric cardiac arrest survival and the availability of ECMO services at the treating hospital.

Main Methods:

  • Utilized the Health Care Utilization Project (HCUP) National Inpatient Sample (NIS) database from 2016-2018.
  • Identified pediatric (0-18 years) cardiac arrest hospitalizations, including in- and out-of-hospital cases.
  • Employed hierarchical logistic regression to assess the association between hospital ECMO capability and in-hospital survival.

Main Results:

  • A total of 1276 pediatric cardiac arrest hospitalizations were analyzed, with an overall survival rate of 44%.
  • Hospitals with ECMO capability demonstrated a higher survival rate (50%) compared to non-ECMO hospitals (32%).
  • Care at an ECMO-capable hospital was associated with significantly higher in-hospital survival (OR 1.49, 95% CI 1.09-2.02), even after adjusting for patient and hospital factors.

Conclusions:

  • Hospital Extracorporeal Membrane Oxygenation (ECMO) capability is associated with increased in-hospital survival for pediatric cardiac arrest patients.
  • Further research is needed to explore care delivery variations and organizational factors influencing pediatric cardiac arrest outcomes.
  • These findings highlight the importance of ECMO availability in improving survival for critically ill children.
Abstract

Keywords:
Cardiac arrestCardiopulmonary resuscitation (CPR)Extracorporeal life support (ECLS)Extracorporeal membrane oxygenation (ECMO)Extracorporeal membrane oxygenation to support cardiopulmonary resuscitation (ECPR)Out of hospital cardiac arrest (OHCA)Pediatric

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