title: Extracorporeal life support for children with meningococcal septicaemia.
abstract: 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.
authors.affiliation: Heartlink ECMO Centre, Glenfield Hospital, Leicester, United Kingdom.
authors.forename: D K
authors.initials: DK
authors.lastname: Luyt
authors.forename: J
authors.initials: J
authors.lastname: Pridgeon
authors.forename: J
authors.initials: J
authors.lastname: Brown
authors.forename: G
authors.initials: G
authors.lastname: Peek
authors.forename: R
authors.initials: R
authors.lastname: Firmin
authors.forename: H C
authors.initials: HC
authors.lastname: Pandya
mesh_terms: 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