title: Diverse Morbidity and Mortality Among Infants Treated with Venoarterial Extracorporeal Membrane Oxygenation.
abstract: BACKGROUND
  Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is utilized for cardiopulmonary failure. We aimed to qualify and quantify the predictors of morbidity and mortality in infants requiring VA-ECMO.
  
  
  METHODS
  Data was collected from 170 centers participating in the extracorporeal life support organization (ELSO) registry. Relationships between in-hospital mortality and risk factors were assessed using logistic regression. Survival was defined as being discharged from the hospital.
  
  
  RESULTS
  Six hundred and sixty-two eligible records were reviewed. Mortality occurred in 303 (46%) infants. Congenital diaphragmatic hernia patients (OR=3.83, 95% CI 1.96-7.49, p<0.001), cardiac failure with associated shock (OR= 2.90, 95% CI 1.46-5.77, p=0.002), and pulmonary failure including respiratory distress syndrome (OR=4.06, 95% CI 1.72-9.58, p=0.001) had the highest odds of mortality in this cohort. Birth weight (BW) < 3 kg (OR=1.83, 95% CI 1.21-2.78, p=0.004), E-CPR (OR=3.35, 95% CI 1.57-7.15, p=0.002), hemofiltration (OR=2.04, 95% CI 1.32-3.16, p=0.001), and dialysis (OR=6.13, 95% CI 1.70-22.1, p<0.001) were all independent predictors of mortality.
  
  
  CONCLUSIONS
  Infants requiring VA-ECMO experience diverse sequelae and their mortality are high.
authors.affiliation: Department of Surgery, Boston Children's Hospital.
authors.forename: Sigrid
authors.initials: S
authors.lastname: Bairdain
authors.affiliation: Department of Respiratory Therapy, Boston Children's Hospital.
authors.forename: Peter
authors.initials: P
authors.lastname: Betit
authors.affiliation: Department of Respiratory Therapy, Boston Children's Hospital.
authors.forename: Nancy
authors.initials: N
authors.lastname: Craig
authors.affiliation: Department of Cardiology, Boston Children's Hospital.
authors.forename: Kimberlee
authors.initials: K
authors.lastname: Gauvreau
authors.affiliation: ELSO Executive administrator, ELSO.
authors.forename: Peter
authors.initials: P
authors.lastname: Rycus
authors.affiliation: Department of Pediatric Surgery, Boston Children's Hospital.
authors.forename: Jay M
authors.initials: JM
authors.lastname: Wilson
authors.affiliation: Department of Cardiology, Boston Children's Hospital.
authors.forename: Ravi
authors.initials: R
authors.lastname: Thiagarajan
keywords: infants; morbidity; mortality; venoarterial extracorporeal membrane oxygenation (va-ecmo)