Outcomes of Extracorporeal Life Support Utilization for Pediatric Patients With COVID-19 Infections

Area of Science:

• Pediatric Critical Care Medicine
• Infectious Diseases
• Cardiopulmonary Support

Background:

• Outcomes for pediatric patients requiring extracorporeal life support (ECLS) for COVID-19 are not well-documented.
• COVID-19 poses significant risks to children, sometimes necessitating advanced respiratory and circulatory support.

Purpose of the Study:

• To evaluate the outcomes of pediatric patients who received ECLS for COVID-19.
• To identify prognostic factors associated with in-hospital mortality in this population.

Main Methods:

• A multi-institutional retrospective observational study included 79 pediatric patients from 14 US centers.
• Data were extracted from electronic medical records for patients treated between January 2020 and July 2022.
• Venovenous (VV) ECLS was the primary modality used in over half of the patients.

Main Results:

• Survival to hospital discharge was 54.4%.
• Nonsurvivors were older, more likely to require renal replacement therapy, had longer intervals from admission to ECLS initiation, and experienced higher rates of ECLS-related complications.
• Neurological deficits were observed in 16.3% of survivors.

Conclusions:

• Pediatric patients with COVID-19 requiring ECLS exhibit significant morbidity.
• Factors like older age, need for renal replacement therapy, delayed ECLS initiation, and ECLS complications are associated with increased mortality.
• Further research is needed to optimize management strategies for this vulnerable group.