Journal article
Venoarterial to venovenous extracorporeal life support conversion in pediatric acute respiratory distress syndrome
Perfusion, Vol.37(4), pp.334-339
05/2022
DOI: 10.1177/02676591211000584
PMID: 33706597
Abstract
In patients with pediatric acute respiratory distress syndrome (PARDS) and hemodynamic compromise who need venoarterial (VA) extracorporeal life support (ECLS), we have adopted a strategy to promote early VA-to-venovenous (VV) conversion since 2018. A single-center retrospective review was performed of all 22 patients who underwent ECLS for PARDS from 2008 to 2019. Variables were analyzed to determine factors affecting initial cannulation mode and in-hospital mortality. Outcomes were compared between before and after 2018. Of the 22 patients, 9 patients underwent initial VA-support. Small patient size and severe cardiopulmonary compromise prior to ECLS favored initial VA- over VV-support. Lactate level and vasoactive inotrope score at 24 hours post-ECLS initiation predicted in-hospital mortality. After 2018, all five patients with initial VA-support were converted to VV-support at 4.4 ± 1.3 days post-ECLS initiation without complications. In-hospital mortality decreased after 2018 (3/9) compared with before (10/13) (p = 0.041) despite longer ECLS run time (723.4 ± 384.2 vs 286.5 ± 235.1 hours, p = 0.003). The number of ECLS-related complications per ECLS 1000 run hours decreased after 2018 (7.2 ± 4.2 vs 46.9 ± 66.5, p = 0.063). Our strategy to promote early VA-to-VV conversion may be worth further evaluation in larger cohort studies.
Details
- Title: Subtitle
- Venoarterial to venovenous extracorporeal life support conversion in pediatric acute respiratory distress syndrome
- Creators
- Yuki Nakamura - University of IowaKristina Rudolph - University of IowaMarco Ricci - University of IowaMarcelo Auslender - University of IowaAditya Badheka - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Perfusion, Vol.37(4), pp.334-339
- DOI
- 10.1177/02676591211000584
- PMID
- 33706597
- ISSN
- 0267-6591
- eISSN
- 1477-111X
- Language
- English
- Date published
- 05/2022
- Academic Unit
- Critical Care; Stead Family Department of Pediatrics; Surgery; Cardiothoracic Surgery
- Record Identifier
- 9984322806502771
Metrics
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