• Wen-Ting Zhao, Wen-Long He, Li-Jun Yang, and Ru Lin.
• Department of HF&MCS, Children's Hospital, Zhejiang University School of Medicine, Zhejiang, 310052, Hangzhou, China.
• Am J Emerg Med. 2024 Sep 1; 83: 253125-31.

ObjectiveWe aimed to investigate the prognostic factors of pediatric extracorporeal cardiopulmonary resuscitation (ECPR).MethodsThe retrospective study included a total of 77 pediatric cases (7 neonates and 70 children) who underwent ECPR after in-hospital and out-of-hospital cardiac arrest between July 2007 and December 2022. Primary endpoints were complications, while secondary endpoints included all-cause in-hospital mortality.ResultsAmong the 45 cases experiencing complications, 4 neonates and 41 children had multiple simultaneous complications, primarily neurological issues in 25 cases. Additionally, organ failure occurred in 11 cases, and immunodeficiency was present in two cases. Furthermore, 9 cases experienced bleeding events, and 13 cases showed thrombosis. Patients with complications had lower weight, shorter ECMO durations, and longer CPR durations. Non-survivors had longer CPR durations and shorter durations of ECMO, ICU stay, and mechanical ventilation compared to survivors. Complications were more prevalent in non-survivors, particularly organ failure and bleeding events.ConclusionWeight, CPR duration, and ECMO duration were associated with complications, suggesting areas for treatment optimization. The higher occurrence of complications in non-survivors underscores the importance of early detection and management to improve survival rates. Our findings suggest clinicians consider these factors in prognostic assessments to enhance the effectiveness of ECPR programs.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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