Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)

Extracorporeal membrane oxygenation (ECMO) is used in pediatric patients with severe cardiopulmonary failure who do not respond to conventional therapy; only a few studies have been conducted in Turkey. We present the experience of pediatric ECMO with the aim of showing factors affecting mort...

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Main Authors: Güntülü Şık, Asuman Demirbuğa, Agageldi Annayev, Bahar Temur, Selim Aydın, Halil İbrahim Demir, Ersin Erek, Agop Çıtak
Format: Article
Language:English
Published: Hacettepe University Institute of Child Health 2020-02-01
Series:The Turkish Journal of Pediatrics
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Online Access:https://turkjpediatr.org/article/view/406
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author Güntülü Şık
Asuman Demirbuğa
Agageldi Annayev
Bahar Temur
Selim Aydın
Halil İbrahim Demir
Ersin Erek
Agop Çıtak
author_facet Güntülü Şık
Asuman Demirbuğa
Agageldi Annayev
Bahar Temur
Selim Aydın
Halil İbrahim Demir
Ersin Erek
Agop Çıtak
author_sort Güntülü Şık
collection DOAJ
description Extracorporeal membrane oxygenation (ECMO) is used in pediatric patients with severe cardiopulmonary failure who do not respond to conventional therapy; only a few studies have been conducted in Turkey. We present the experience of pediatric ECMO with the aim of showing factors affecting mortality. We retrospectively reviewed our ECMO database to identify patients who received ECMO from October 2015 to March 2018. Our population comprised 30 pediatric patients. The mean patient age was 41.31±53.35 months and 17 (56.7%) patients were male. The median duration of ECMO support was 8.9 (6.6-10.8) days. The rates of successful ECMO weaning and survival to discharge were 70.0% (n=21) and 66.7% (n=20), respectively. Indications for ECMO were respiratory failure (40.0%), cardiac failure (33.3%), and sepsis (26.7%). We found that pre-cannulation values of pH (p=0.034), leukocytes (p=0.029), C-reactive protein (p=0.045), creatinine (p=0.047), chloride (p=0.001) and post-cannulation pH (p=0.0001), bicarbonate (p=0.014), lactate (p=0.002), chloride (p=0.0001) were associated with mortality. The results showed that preexisting sepsis and renal conditions contributed to poor outcomes. Indications, ECMO onset time, and pre- and post-cannulation laboratory values such as leukocytes, CRP, creatinine, bicarbonate, lactate, and chloride are factors that affect outcomes.
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id doaj-art-4d988af091904a08a6657f8a68234e39
institution OA Journals
issn 0041-4301
2791-6421
language English
publishDate 2020-02-01
publisher Hacettepe University Institute of Child Health
record_format Article
series The Turkish Journal of Pediatrics
spelling doaj-art-4d988af091904a08a6657f8a68234e392025-08-20T02:01:47ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212020-02-0162110.24953/turkjped.2020.01.004Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)Güntülü Şık0Asuman Demirbuğa1Agageldi Annayev2Bahar Temur3Selim Aydın4Halil İbrahim Demir5Ersin Erek6Agop Çıtak7Departments of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Pediatric Cardiology, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Cardiovascular Surgery, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey.Departments of Pediatric Intensive Care, Acıbadem Mehmet Ali Aydınlar University, İstanbul, Turkey. Extracorporeal membrane oxygenation (ECMO) is used in pediatric patients with severe cardiopulmonary failure who do not respond to conventional therapy; only a few studies have been conducted in Turkey. We present the experience of pediatric ECMO with the aim of showing factors affecting mortality. We retrospectively reviewed our ECMO database to identify patients who received ECMO from October 2015 to March 2018. Our population comprised 30 pediatric patients. The mean patient age was 41.31±53.35 months and 17 (56.7%) patients were male. The median duration of ECMO support was 8.9 (6.6-10.8) days. The rates of successful ECMO weaning and survival to discharge were 70.0% (n=21) and 66.7% (n=20), respectively. Indications for ECMO were respiratory failure (40.0%), cardiac failure (33.3%), and sepsis (26.7%). We found that pre-cannulation values of pH (p=0.034), leukocytes (p=0.029), C-reactive protein (p=0.045), creatinine (p=0.047), chloride (p=0.001) and post-cannulation pH (p=0.0001), bicarbonate (p=0.014), lactate (p=0.002), chloride (p=0.0001) were associated with mortality. The results showed that preexisting sepsis and renal conditions contributed to poor outcomes. Indications, ECMO onset time, and pre- and post-cannulation laboratory values such as leukocytes, CRP, creatinine, bicarbonate, lactate, and chloride are factors that affect outcomes. https://turkjpediatr.org/article/view/406chlorideextracorporeal membrane oxygenationlactatepediatric intensive care
spellingShingle Güntülü Şık
Asuman Demirbuğa
Agageldi Annayev
Bahar Temur
Selim Aydın
Halil İbrahim Demir
Ersin Erek
Agop Çıtak
Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
The Turkish Journal of Pediatrics
chloride
extracorporeal membrane oxygenation
lactate
pediatric intensive care
title Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
title_full Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
title_fullStr Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
title_full_unstemmed Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
title_short Clinical and laboratory predictors of survival for pediatric patients on non-postcardiotomy extracorporeal membrane oxygenation (ECMO)
title_sort clinical and laboratory predictors of survival for pediatric patients on non postcardiotomy extracorporeal membrane oxygenation ecmo
topic chloride
extracorporeal membrane oxygenation
lactate
pediatric intensive care
url https://turkjpediatr.org/article/view/406
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