Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality?
Background: Data is limited regarding the effects of supraphysiologic blood oxygen tension (hyperoxia) in patients requiring extracorporeal life support (ECLS). We sought to evaluate the association between hyperoxia and outcomes in pediatric patients requiring veno-venous (VV) ECLS. Methods: Retros...
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EDP Sciences
2025-06-01
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| Series: | The Journal of ExtraCorporeal Technology |
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| Online Access: | https://ject.edpsciences.org/articles/ject/full_html/2025/02/ject240009/ject240009.html |
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| author | Beshish Asaad G. Rodriguez-Morales Paola Shamah Rebecca Qian Joshua Keane-Lerner Kasey Zinyandu Tawanda Davis Joel Rosenblum Joshua M. Viamonte Heather K. |
| author_facet | Beshish Asaad G. Rodriguez-Morales Paola Shamah Rebecca Qian Joshua Keane-Lerner Kasey Zinyandu Tawanda Davis Joel Rosenblum Joshua M. Viamonte Heather K. |
| author_sort | Beshish Asaad G. |
| collection | DOAJ |
| description | Background: Data is limited regarding the effects of supraphysiologic blood oxygen tension (hyperoxia) in patients requiring extracorporeal life support (ECLS). We sought to evaluate the association between hyperoxia and outcomes in pediatric patients requiring veno-venous (VV) ECLS. Methods: Retrospective single-center study at an academic children’s hospital, Children’s Healthcare of Atlanta, Emory University School of Medicine that included all patients 0–18 years who required VV-ECLS between 01/2014 and 12/2019. Results: During the study period 110 VV-ECLS runs occurred in 110 patients. Using a receiver operating characteristic curve, a mean partial pressures of oxygen (PaO2) of 122 mmHg in the first 48 hours of ECLS was determined to have the optimal discriminatory ability with regard to mortality (sensitivity 41% and specificity 86%). Of the VV-ECLS runs, 68 (61.8%) had PaO2 > 122 mmHg (hyperoxia group). The hyperoxia group tended to be older (105.4 vs. 1.6 months, p = 0.001), had higher rates of hemorrhagic complications (69.6% vs. 25.3%, p = 0.0001), and higher mortality rate (57.9% vs. 19.5%, p = 0.002). Adjusting for confounders, the hyperoxia group had higher odds of mortality (OR: 7.97, 95% CI: 1.72–36.86, p = 0.0079). Conclusion: Children exposed to hyperoxia during the first 48 h of VV-ECLS were 8 times more likely to die than those who were not after adjusting for confounders (age group, body surface area, and indication for ECLS). Multicenter and prospective evaluation of this modifiable risk factor is imperative to improving the care of this high-risk cohort. |
| format | Article |
| id | doaj-art-09ce7ae1152f4ce4b14822a36b0179ea |
| institution | DOAJ |
| issn | 0022-1058 2969-8960 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | EDP Sciences |
| record_format | Article |
| series | The Journal of ExtraCorporeal Technology |
| spelling | doaj-art-09ce7ae1152f4ce4b14822a36b0179ea2025-08-20T03:22:11ZengEDP SciencesThe Journal of ExtraCorporeal Technology0022-10582969-89602025-06-01572596510.1051/ject/2024013ject240009Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality?Beshish Asaad G.0https://orcid.org/0000-0003-2893-6882Rodriguez-Morales Paola1Shamah Rebecca2Qian Joshua3Keane-Lerner Kasey4Zinyandu Tawanda5Davis Joel6Rosenblum Joshua M.7Viamonte Heather K.8Department of Pediatrics, Division of Cardiology, Emory University School of Medicine, Children’s Healthcare of AtlantaEmory University School of MedicineEmory University School of MedicineEmory University School of MedicineChildren’s Healthcare of AtlantaChildren’s Healthcare of AtlantaECMO and Advanced Technologies, Children’s Healthcare of AtlantaDepartment of Surgery, Division of Cardiothoracic Surgery, Emory University School of Medicine, Children’s Healthcare of AtlantaDepartment of Pediatrics, Division of Cardiology, Emory University School of Medicine, Children’s Healthcare of AtlantaBackground: Data is limited regarding the effects of supraphysiologic blood oxygen tension (hyperoxia) in patients requiring extracorporeal life support (ECLS). We sought to evaluate the association between hyperoxia and outcomes in pediatric patients requiring veno-venous (VV) ECLS. Methods: Retrospective single-center study at an academic children’s hospital, Children’s Healthcare of Atlanta, Emory University School of Medicine that included all patients 0–18 years who required VV-ECLS between 01/2014 and 12/2019. Results: During the study period 110 VV-ECLS runs occurred in 110 patients. Using a receiver operating characteristic curve, a mean partial pressures of oxygen (PaO2) of 122 mmHg in the first 48 hours of ECLS was determined to have the optimal discriminatory ability with regard to mortality (sensitivity 41% and specificity 86%). Of the VV-ECLS runs, 68 (61.8%) had PaO2 > 122 mmHg (hyperoxia group). The hyperoxia group tended to be older (105.4 vs. 1.6 months, p = 0.001), had higher rates of hemorrhagic complications (69.6% vs. 25.3%, p = 0.0001), and higher mortality rate (57.9% vs. 19.5%, p = 0.002). Adjusting for confounders, the hyperoxia group had higher odds of mortality (OR: 7.97, 95% CI: 1.72–36.86, p = 0.0079). Conclusion: Children exposed to hyperoxia during the first 48 h of VV-ECLS were 8 times more likely to die than those who were not after adjusting for confounders (age group, body surface area, and indication for ECLS). Multicenter and prospective evaluation of this modifiable risk factor is imperative to improving the care of this high-risk cohort.https://ject.edpsciences.org/articles/ject/full_html/2025/02/ject240009/ject240009.htmlextracorporeal life support (ecls)hyperoxiaveno-veno extracorporeal life support (vv-ecls)mortalityfunctional status scale (fss) |
| spellingShingle | Beshish Asaad G. Rodriguez-Morales Paola Shamah Rebecca Qian Joshua Keane-Lerner Kasey Zinyandu Tawanda Davis Joel Rosenblum Joshua M. Viamonte Heather K. Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? The Journal of ExtraCorporeal Technology extracorporeal life support (ecls) hyperoxia veno-veno extracorporeal life support (vv-ecls) mortality functional status scale (fss) |
| title | Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? |
| title_full | Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? |
| title_fullStr | Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? |
| title_full_unstemmed | Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? |
| title_short | Is hyperoxia in early pediatric veno-veno extracorporeal life support associated with mortality? |
| title_sort | is hyperoxia in early pediatric veno veno extracorporeal life support associated with mortality |
| topic | extracorporeal life support (ecls) hyperoxia veno-veno extracorporeal life support (vv-ecls) mortality functional status scale (fss) |
| url | https://ject.edpsciences.org/articles/ject/full_html/2025/02/ject240009/ject240009.html |
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