Prone Position Ventilation for Pediatric Acute Respiratory Distress Syndrome with Extracorporeal Membrane Oxygenation: A Propensity Score-Matched Retrospective Multicenter Cohort Study

Abstract

Background: Extracorporeal membrane oxygen (ECMO) has used for rescuing severe pediatric acute respiratory distress syndrome (PARDS) for half a century. Prone position ventilation (PPV) has been suggested according to the surviving sepsis campaign (SSC) guideline in children in 2020. We aimed to compare the outcomes and effect of PARDS patients with ECMO+PPV and ECMO only. Design: Retrospective Multicenter pair-matched Study Setting: In the present study, propensity score matching was conducted and the outcomes of severe PARDS patients were analyzed. The effect of PPV was compared as well. The e ciency of PPV included PaO 2 , Oxygen Index (OI), PaO 2 /FiO 2 , compliance of respiratory system and resistance of airway. The primary outcome was hospital mortality. Secondary outcomes included ECMO running time, PICU time, hospital days and mechanical ventilation time of survivors. Patients: 137 PARDS patients with criteria of ECMO from 11 hospitals in 5 years. Interventions: No interventions. Measurements and Main Results: Among 137 patients, 93 patients received ECMO+PPV at the same time and 44 patients didn't. After matching, we got 34 pairs. For the survivors receiving ECMO+PPV, the PaO 2 ,