Annals of intensive care · 2026
Characteristics and outcomes of pediatric extracorporeal cardiopulmonary resuscitation (E-CPR): a nationwide retrospective analysis from the French pediatric ECMO Network.
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Bernardon R, Bulescu N C, Blache T, Pavy C, Grimaud M, Rambaud J, Langouet E, Clairaz A, Delangue S, Berthomieu L, Denante S, Joram N, Chenouard A, Gaultier A, Bourgoin P, French Pediatric ECMO Network
Аннотация
OBJECTIVE: To report the incidence and outcomes of E-CPR for intra or extra-hospital pediatric refractory cardiac arrest (CA) within the French national pediatric ECMO (Extra Corporeal Membrane Oxygenation) network.
METHODS: Retrospective study. Children (0-18 years) who underwent E-CPR for intra or extra-hospital cardiac arrest over a 5-year period (2019-2023) in one of the centers belonging to the network were included for analysis.
RESULTS: A total of 164 patients were included for analysis. Centers reported a median of 6 cases (range: 0-21). Most patients received E-CPR for intra-hospital CA (150, 91.5%), with cardiac origin suspected in 134 (84.3%) patients. Preexistent cardiac disease was reported in 94 patients (57.3%). Survival rate at PICU discharge, hospital discharge and after one-year was 29.9%, 29.3% and 27.4% respectively. We identified male gender (aOR 2.74, 95%CI 1.22 to 6.14, p = 0.014) and higher serum lactate 24 h after CA (aOR 1.11 per mol/L, 95%CI 1.03-1.18, p = 0.003) as independent factors associated with poor prognosis whereas femoral cannulation site (aOR 0.18, 95%CI 0.06 to 0.52, p = 0.002) was associated with favorable outcome.
CONCLUSION: E-CPR is mostly performed in children with heart disease, with limited use in out-of-hospital settings. Efforts should be made to identify patients in need of ECMO before CA, as the outcome after E-CPR remains poor.
METHODS: Retrospective study. Children (0-18 years) who underwent E-CPR for intra or extra-hospital cardiac arrest over a 5-year period (2019-2023) in one of the centers belonging to the network were included for analysis.
RESULTS: A total of 164 patients were included for analysis. Centers reported a median of 6 cases (range: 0-21). Most patients received E-CPR for intra-hospital CA (150, 91.5%), with cardiac origin suspected in 134 (84.3%) patients. Preexistent cardiac disease was reported in 94 patients (57.3%). Survival rate at PICU discharge, hospital discharge and after one-year was 29.9%, 29.3% and 27.4% respectively. We identified male gender (aOR 2.74, 95%CI 1.22 to 6.14, p = 0.014) and higher serum lactate 24 h after CA (aOR 1.11 per mol/L, 95%CI 1.03-1.18, p = 0.003) as independent factors associated with poor prognosis whereas femoral cannulation site (aOR 0.18, 95%CI 0.06 to 0.52, p = 0.002) was associated with favorable outcome.
CONCLUSION: E-CPR is mostly performed in children with heart disease, with limited use in out-of-hospital settings. Efforts should be made to identify patients in need of ECMO before CA, as the outcome after E-CPR remains poor.