Long-Term Survival Outcomes and Causes of Late Death in Neonates, Infants, and Children Treated With Extracorporeal Life Support*

Abstract

Although the majority of deaths were early, late mortality was observed following extracorporeal life support. Late deaths were more prevalent in children with underlying complex long-term conditions, particularly heart disease and congenital diaphragmatic hernia. Evaluation of longer term survival is an important component of audit for extracorporeal life support outcomes.

Pulmonary support on day of life 30 is a strong predictor of increased 1 and 5-year morbidity in survivors of congenital diaphragmatic hernia

“…A recent large-scale study of CDH patients using ECMO found that even in those patients who survive at least 90 days, only 74% are alive at five years. (26) Interestingly, in the present study of patients followed in a multidisciplinary clinic, we found a much lower rate of late death for patients surviving the initial hospitalization (1.5%). While it is difficult to determine if this low rate of late deaths was secondary to the center’s multidisciplinary clinic, other smaller studies of CDH patients with multi-specialty follow up have suggested similar outcomes.…”

Extracorporeal membrane oxygenation for neonatal collapse caused by enterovirus myocarditis

“…All three of our survivors had a favourable cardiac outcome demonstrated by normal echocardiographic findings at last follow-up. Iguchi et al reported on long-term survival outcomes and causes of late death in neonates, infants and children treated with ECMO 26. They identified five children who died several years after having been weaned from ECLS after apparent recovery from myocarditis.…”

Paediatric ECMO at low‐volume paediatric cardiac centres in the Nordic countries

“…In the study by Chrysostomou et al., a significantly higher survival was seen in the cardiac group, while four studies reported significantly lower survival in the cardiac group compared with the Nordic centres. Two single‐centre studies from UK on respiratory ECMO from high volume centres reported similar outcome compared with our data.…”

“…Outcome from the three Nordic Centres was compared with the ELSO register in the same period. In order to compare specifically with high‐volume centres, outcome data from the present study was compared with previously published data from larger centres …”