Mortality and Factors Associated With Hemorrhage During Pediatric Extracorporeal Membrane Oxygenation

Objectives: To quantify and identify factors associated with bleeding events during pediatric extracorporeal membrane oxygenation. Design: Retrospective cohort study with primary outcome of bleeding days on extracorporeal membrane oxygenation. Setting: Single tertiary care children’s hospital. Subjects: One-hundred twenty-two children supported with extracorporeal membrane oxygenation for greater than 12 hours during January 2015 through December 2016. Interventions: Bleeding days were identified if mediastinal or cannula site exploration, activated factor VII administration, gastrointestinal, pulmonary, or intracranial hemorrhages occurred. Logistic regression was used to assess factors associated with bleeding days. Measurements and Main Results: Study population was identified from institutional extracorporeal membrane oxygenation database. Clinical, laboratory, and survival data were obtained from medical records. Only data from patients’ first extracorporeal membrane oxygenation run were used. One-hundred twenty-two patients with median age of 17 weeks (interquartile range, 1–148 wk) were analyzed. Congenital heart disease (n = 56, 46%) was the most common diagnosis. Bleeding days comprised 179 (16%) of the 1,121 observed extracorporeal membrane oxygenation-patient-days. By extracorporeal membrane oxygenation day 4, 50% of users had experienced a bleeding day. Central rather than peripheral cannulation (odds ratio, 2.58; 95% CI, 1.47–4.52; p
Source: Pediatric Critical Care Medicine - Category: Pediatrics Tags: Extracorporeal Support Source Type: research