title: Paediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies.
  
  
  METHODS
  One-hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high-volume single-centre studies.
  
  
  RESULTS
  Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high-volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high-volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high-volume centres.
  
  
  CONCLUSIONS
  Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres.
authors.affiliation: Department of Anaesthesia and Intensive Care, University Hospital of Aarhus, Aarhus N, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Veien
authors.forename: L
authors.initials: L
authors.lastname: Lindberg
authors.forename: P
authors.initials: P
authors.lastname: Tynkkynen
authors.forename: H B
authors.initials: HB
authors.lastname: Ravn
mesh_terms: D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000706:statistics & numerical data*; D005260:Female; D006331:Heart Diseases / Q000453:epidemiology / Q000628:therapy*; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000453:epidemiology / Q000628:therapy*; D008297:Male; D012042:Registries / Q000706:statistics & numerical data; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D016019:Survival Analysis