• Jessica A Barreto, Amit Mehta, Ravi R Thiagarajan, Kristen N Hayward, Adrian Brogan, and Thomas V Brogan.
• Department of Pediatrics, Division of Critical Care Medicine, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA.
• Pediatr Crit Care Me. 2022 Jan 1; 23 (1): e60e65e60-e65.

ObjectivesTo describe the use and outcomes of extracorporeal membrane oxygenation support among children with immune-mediated conditions.DesignRetrospective cohort study.SettingThe Extracorporeal Life Support Organization registry.PatientsPatients 1 month to 18 years old with International Classification of Diseases, 9th Edition and International Classification of Diseases, 10th Edition codes for immune-mediated conditions from 1989 to 2018.InterventionsNone.Measurements And Main ResultsDuring the study period, 207 patients with an immune-mediated condition received extracorporeal membrane oxygenation, and 50% survived to discharge. Most patients (63%) received extracorporeal membrane oxygenation for respiratory support with 53% survival, 21% received cardiac support (55% survival), and 15% received extracorporeal cardiopulmonary resuscitation (34% survival). The most common diagnosis among nonsurvivors was hemophagocytic lymphohistiocytosis/macrophage activation syndrome with 37% survival. Patients with juvenile idiopathic arthritis (23%) and dermatomyositis (25%) had the lowest survival. Nonsurvivors had a higher frequency of infections, neurologic complications, and renal replacement therapy use. Use of preextracorporeal membrane oxygenation corticosteroids was associated with mortality.ConclusionsChildren with immune-mediated conditions can be successfully supported with extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation use has increased over time, and survival varies considerably by diagnosis.Copyright © 2021 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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