Extracorporeal life support for children with meningococcal septicaemia.
OBJECTIVE
To describe the short-term outcome of children with meningococcal sepsis treated with extracorporeal membrane oxygenation (ECMO) in a single centre.


METHODS
Retrospective analysis of case notes.


METHODS
The Heartlink ECMO Centre, Glenfield Hospital, Leicester.


METHODS
Eleven children (8 boys) out of a total caseload of 800 patients were treated for meningococcal sepsis with ECMO.


METHODS
Extracorporeal membrane oxygenation.


RESULTS
All children with meningococcal sepsis treated with ECMO had a Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) > or = 12 (positive predictive risk of death of approximately 90%). Five children had adult respiratory distress syndrome (ARDS) and six had refractory shock with multi-organ dysfunction syndrome (MODS) at presentation for ECMO. All five children in the ARDS group survived, four of five receiving veno-venous (VV-) ECMO therapy. In contrast, only one of six children with refractory shock with MODS survived, all of whom required veno-arterial (VA-) ECMO therapy.


CONCLUSIONS
Most children with meningococcal sepsis and severe ARDS can be successfully treated with VV-ECMO. In contrast, children with refractory shock and MODS die despite treatment with VA-ECMO. This report does not resolve whether ECMO therapy offers any advantage over conventional therapy in treating severe meningococcal sepsis.
Luyt
D K
DK
Heartlink ECMO Centre, Glenfield Hospital, Leicester, United Kingdom.
Pridgeon
J
J
Brown
J
J
Peek
G
G
Firmin
R
R
Pandya
H C
HC
D002648:Child; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D008020:Life Support Care / Q000295:instrumentation*; D008297:Male; D008589:Meningococcal Infections / Q000150:complications* / Q000628:therapy*; D009102:Multiple Organ Failure / Q000209:etiology / Q000503:physiopathology; D012042:Registries; D012128:Respiratory Distress Syndrome / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D018805:Sepsis / Q000382:microbiology*; D012720:Severity of Illness Index