• R Caballero, R H Clark, and J A Wright.
• Division of Critical Care, Cook Children's Medical Center, Fort Worth, Texas, USA.
• Clin Pediatr (Phila). 1996 Apr 1; 35 (4): 199-204.

AbstractDespite the availability of ECMO (extracorporeal membrane oxygenation) services for nearly a decade, the criteria for the institution of ECMO for pediatric respiratory failure are still not clearly defined. Therefore, a chart review was performed on children who were mechanically ventilated more than 48 hours in 1989-1990 in order to evaluate possible predictors of death from pediatric respiratory failure. Twenty-three children died as a consequence of respiratory failure. Nonsurvivors in both years were compared with the 78 survivors in 1990, and potential predictors were subjected to multivariate analysis. After 4 days of mechanical ventilation, an alveolar-arterial oxygen gradient (AaDO2) greater than 400 torr (53.3 kPa) was a weak predictor of death due to respiratory failure, and yet an AaDO2 less than 400 torr (53.3 kPa) was a stronger predictor of survivability. Combination of variables did not yield a better predictor than any single variable. Early prediction of mortality from respiratory failure in this population was not found.

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