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Extracorporeal membrane oxygenation for paediatric refractory hypoxic respiratory failure caused by adenovirus in Shanghai: a case series.
Cui, Yun; Shi, Jingyi; Zhou, Yiping; Dou, Jiaying; Xiong, Xi; Sun, Ting; Shan, Yijun; Xu, Tingting; Lu, Ye; Zhang, Yucai.
  • Cui Y; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Shi J; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Zhou Y; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Dou J; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Xiong X; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Sun T; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Shan Y; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Xu T; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Lu Y; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China.
  • Zhang Y; Department of Critical Care Medicine, Shanghai Children's Hospital, Shanghai Jiao Tong University School of Medicine, No.355 Luding Road, Putuo District, Shanghai, 200062, China. zyucai2018@163.com.
BMC Pediatr ; 22(1): 138, 2022 03 16.
Article in English | MEDLINE | ID: covidwho-2038685
ABSTRACT

BACKGROUND:

To assess the outcome of extracorporeal membrane oxygenation (ECMO) for severe adenovirus (Adv) pneumonia with refractory hypoxic respiratory failure (RHRF) in paediatric patients.

METHODS:

A retrospective observational study was performed in a tertiary paediatric intensive care unit (PICU) in China. Patients with RHRF caused by Adv pneumonia who received ECMO support after mechanical ventilation failed to achieve adequate oxygenation between 2017 and 2020 were included. The outcome variables were the in-hospital survival rate and the effects of ECMO on the survival rate.

RESULTS:

In total, 18 children with RHRF received ECMO. The median age was 19 (9.5, 39.8) months, and the median ECMO duration was 196 (152, 309) h. The in-hospital survival rate was 72.2% (13/18). Thirteen patients (72.2%) required continuous renal replacement therapy (CRRT) due to fluid imbalance or acute kidney injury (AKI). At ECMO initiation, compared with survivors, nonsurvivors had a lower PaO2/FiO2 ratio [49 (34.5, 62) vs. 63 (56, 71); p = 0.04], higher oxygen index (OI) [41 (34.5, 62) vs. 30 (26.5, 35); p = 0.03], higher vasoactive inotropic score (VIS) [30 (16.3, 80) vs. 100 (60, 142.5); p = 0.04], longer duration from mechanical ventilation to ECMO support [8 (4, 14) vs. 4 (3, 5.5) h, p=0.02], and longer time from confirmed RHRF to ECMO initiation [9 (4.8, 13) vs. 5 (1.3, 5.5) h; p = 0.004]. Patients with PaO2/FiO2 <61 mmHg or an OI >43 and hypoxic respiratory failure for more than 9 days before the initiation of ECMO had worse outcomes.

CONCLUSIONS:

ECMO seemed to be effective, as severe paediatric Adv pneumonia patients with RHRF had a cumulative survival rate of 72.2% in our study. Our study provides insight into ECMO rescue in children with severe Adv pneumonia.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Insufficiency / Extracorporeal Membrane Oxygenation / Adenoviridae Infections Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Child / Humans / Young adult Country/Region as subject: Asia Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03197-2

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Respiratory Insufficiency / Extracorporeal Membrane Oxygenation / Adenoviridae Infections Type of study: Observational study / Prognostic study Topics: Long Covid Limits: Adult / Child / Humans / Young adult Country/Region as subject: Asia Language: English Journal: BMC Pediatr Journal subject: Pediatrics Year: 2022 Document Type: Article Affiliation country: S12887-022-03197-2