title: Pediatric ECMO outcomes: comparison of centrifugal versus roller blood pumps using propensity score matching.
abstract: Centrifugal blood pumps are being increasingly utilized in children supported with extracorporeal membrane oxygenation (ECMO). Our aim was to determine if survival and ECMO-related morbidities in children supported with venoarterial (VA) ECMO differed by blood pump type.Children aged less than 18 years who underwent VA ECMO support from 2007 to 2009 and reported to the Extracorporeal Life Support Organization registry were propensity score matched (Greedy 1:1 matching) using pre-ECMO characteristics.A total of 2,656 (centrifugal = 2,231, roller = 425) patients were identified and 548 patients (274 per pump type) were included in the propensity score-matched cohort. Children supported with centrifugal pumps had increased odds of hemolysis (odds ratio [OR], 4.03 95% confidence interval [CI], 2.37-6.87), hyperbilirubinemia (OR, 5.48; 95% CI, 2.62-11.49), need for inotropic support during ECMO (OR, 1.54; 95% CI, 1.09-2.17), metabolic alkalosis (blood pH > 7.6) during ECMO (OR, 3.13; 95% CI, 1.49-6.54), and acute renal failure (OR, 1.61; 95% CI, 1.10-2.39). Survival to hospital discharge did not differ by pump type.In a propensity score-matched cohort of pediatric ECMO patients, children supported with centrifugal pumps had increased odds of ECMO-related complications. There was no difference in survival between groups.
authors: Department of Cardiology, Children's Hospital Colorado and Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO 80045, USA. cindy.barrett@childrenscolorado.org
authors: Cindy S
authors: CS
authors: Barrett
authors: James J
authors: JJ
authors: Jaggers
authors: E Francis
authors: EF
authors: Cook
authors: Dionne A
authors: DA
authors: Graham
authors: Vasmi V
authors: VV
authors: Yarlagadda
authors: Sarah A
authors: SA
authors: Teele
authors: Christopher S
authors: CS
authors: Almond
authors: Susan L
authors: SL
authors: Bratton
authors: John D
authors: JD
authors: Seeger
authors: Heidi J
authors: HJ
authors: Dalton
authors: Peter T
authors: PT
authors: Rycus
authors: Peter C
authors: PC
authors: Laussen
authors: Ravi R
authors: RR
authors: Thiagarajan
mesh_terms: D000293:Adolescent; D002498:Centrifugation; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000401:mortality; D005260:Female; D006461:Hemolysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008280:Magnetics; D008297:Male; D057216:Propensity Score