October 09, 2017
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Families of children treated with ECMO report certain favorable outcomes

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Matthew D. Elias

Family-reported outcomes of pediatric cardiac patients once supported by extracorporeal membrane oxygenation, or ECMO, were encouraging, according to findings published in Pediatric Critical Care Medicine.

Matthew D. Elias, MD, pediatric cardiologist at the Children’s Hospital of Philadelphia, and colleagues conducted a retrospective study of 396 patients (59% male; 66% white; median age at cannulation, 78 days) treated with ECMO at the Children’s Hospital of Philadelphia between 1995 and 2012.

Among the cohort, one of the largest pediatric ECMO cohorts assembled, 86% had congenital heart disease, 71% had surgery before ECMO, 53% had cardiopulmonary arrest as the primary indication for ECMO and 43% survived to discharge.

Among those who survived to discharge, 38% of patients and families completed a phone survey and 19% completed a written survey assessing morbidity, quality of life and other factors.

At 6-year median follow-up, 66% of patients were known to be deceased, and 38 patients were known to have died after discharge, Elias and colleagues wrote.

In the verbal surveys, 82% of respondents reported positive outcomes, with 50.8% reporting current health as excellent and 40% reporting it as good.

Most respondents reported no (47.7%) or mild (38.5%) physical limitations, according to the researchers.

Elias and colleagues wrote that 23.3% of parents reported their child had below-average performance in school and 46.8% reported their child had learning difficulties.

Among children younger than 13 years, quality-of-life scores were lower than the normative total scores for healthy individuals in that age group (P < .001), but that was not the case for adolescents, regardless of whether scores were self-reported (P = .072) or proxy-reported (P = .058), the researchers wrote.

No variables related to the index ECMO use were related to the composite outcome of current health status or physical limitations, they wrote.

“Our findings should allow for improved family counseling in discussing long-term quality of life for children with heart disease,” Elias said in a press release. – by Erik Swain

Disclosure: One author reports she receives funding from Danone Medical.