• Michael Colin Mowrer, Lisa Lima, Rohit Nair, Xilong Li, Hitesh Sandhu, Brian Bridges, Ryan P Barbaro, Saleh Bhar, Raymond Nkwantabisa, Saad Ghafoor, Agnes Reschke, Taylor Olson, Matthew P Malone, Neel Shah, Matt S Zinter, Jon Gehlbach, Laura Hollinger, Briana L Scott, LernerReut KassifRKDepartment of Pediatric Intensive Care, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Israel., Thomas V Brogan, Lakshmi Raman, and Renee M Potera.
• Division of Critical Care Medicine, Cook Children's Medical Center, Fort Worth, TX.
• Pediatr Crit Care Me. 2024 Nov 1; 25 (11): 102610341026-1034.

ObjectiveTo describe characteristics associated with survival for pediatric patients with an oncologic diagnosis or hematopoietic cell transplant (HCT) supported with extracorporeal membrane oxygenation (ECMO).DesignMulticenter, retrospective study.SettingSixteen PICUs in the United States and Israel.PatientsWe included patients aged younger than 19 years with an oncologic diagnosis or HCT who required ECMO support between 2009 and 2021.InterventionsNone.Measurements And Main ResultsA total of 149 patients were included in the study cohort. There were 118 patients with an oncologic diagnosis and 31 that received HCT. The indications for ECMO were respiratory failure (46%), combined respiratory and cardiac failure (28%), and cardiac failure (25%). Venovenous (V-V) ECMO was used in 45% of patients, with 53% of patients being placed on venoarterial (V-A) ECMO. For oncologic and HCT groups, survival to ECMO decannulation was 52% (62/118) and 64% (20/31), and survival to hospital discharge was 36% (43/118) and 42% (13/31), respectively. After adjusting for other factors, requiring cardiopulmonary resuscitation was associated with greater odds ratio of mortality (3.0 [95% CI, 1.2-7.7]).ConclusionsSurvival to ECMO decannulation of pediatric oncologic and HCT patients in this study was 52-64%, depending upon diagnosis. However, survival to hospital discharge remains poor. Future research should prioritize understanding factors contributing to this survival gap within these patient populations.Copyright © 2024 by the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies.

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