title: Pediatric extracorporeal life support after high frequency ventilation: predictors of survival.
abstract: Previous studies of extracorporeal life support in pediatric patients have identified variables associated with survival. However, none of these studies focused on extracorporeal life support after failure of high frequency ventilation (HFV). In the present study, we determined variables associated with survival for pediatric respiratory failure patients who received HFV prior to extracorporeal life support, using data reported to the Extracorporeal Life Support Organization Registry from 1992 to 1998. Patients with neonatal diagnoses, immune compromising conditions, or congenital cardiac defects were excluded. The 243 patients who met inclusion criteria had a 58% survival rate (95% CI 48-66%). The mean age was 22 +/- 39 months. Mean duration of mechanical ventilation prior to extracorporeal life support was 6.6 +/- 5.8 days. Venoarterial extracorporeal life support was used in 72% of the patients; venovenous in 28%. The survival rate for the subset of patients with an oxygenation index greater than 42 cm H2O/torr on HFV (n = 122) was not significantly different from the overall sample. We determined that lower mean airway pressure, lower pressure amplitude, decreased oxygenation index, increased PaO2, and increased oxygen saturation on HFV were associated with increased survival in patients who were subsequently treated with extracorporeal life support.
authors.affiliation: Department of Pediatrics, University of Arizona, Tucson 85724-5073, USA.
authors.forename: Robyn J
authors.initials: RJ
authors.lastname: Meyer
authors.forename: Frank W
authors.initials: FW
authors.lastname: Moler
authors.forename: Norma J
authors.initials: NJ
authors.lastname: Maxvold
authors.forename: Gail M
authors.initials: GM
authors.lastname: Annich
authors.forename: Folafoluwa O
authors.initials: FO
authors.lastname: Odetola
authors.forename: Roxanne
authors.initials: R
authors.lastname: Sadowski
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Custer
mesh_terms: D000293:Adolescent; D002245:Carbon Dioxide / Q000097:blood; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005112:Extracorporeal Circulation / Q000401:mortality*; D005260:Female; D006612:High-Frequency Ventilation / Q000401:mortality*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D010100:Oxygen / Q000097:blood; D011237:Predictive Value of Tests; D012131:Respiratory Insufficiency / Q000401:mortality* / Q000628:therapy*
chemical_list: D002245:Carbon Dioxide; D010100:Oxygen