Paediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries

Acta Anaesthesiol Scand. 2015 Mar;59(3):337-45. doi: 10.1111/aas.12460. Epub 2015 Jan 13.

Abstract

Background: Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies.

Methods: One-hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high-volume single-centre studies.

Results: Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high-volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high-volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high-volume centres.

Conclusions: Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres.

Publication types

  • Multicenter Study

MeSH terms

  • Child, Preschool
  • Extracorporeal Membrane Oxygenation / statistics & numerical data*
  • Female
  • Heart Diseases / epidemiology
  • Heart Diseases / therapy*
  • Hospitals, Pediatric / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Lung Diseases / epidemiology
  • Lung Diseases / therapy*
  • Male
  • Registries / statistics & numerical data
  • Scandinavian and Nordic Countries / epidemiology
  • Survival Analysis