title: Effect of timing of cannulation on outcome for pediatric extracorporeal life support.
abstract: OBJECTIVE
  Literature reports worse outcomes for operations performed during off-hours. As this has not been studied in pediatric extracorporeal life support (ECLS), we compared complications based on the timing of cannulation..
  
  
  METHODS
  This is a retrospective review of 176 pediatric ECLS patients between 2004 and 2015. Patients cannulated during daytime hours (7:00 A.M. to 7:00 P.M., M-F) were compared to off-hours (nighttime or weekend) using t-test and Chi-square.
  
  
  RESULTS
  The most common indications for ECLS were congenital diaphragmatic hernia (33 %) and persistent pulmonary hypertension (23 %). When comparing regular hours (40 %) to off-hours cannulation (60 %), there were no significant differences in central nervous system complications, hemorrhage (extra-cranial), cannula repositioning, conversion from venovenous to venoarterial, mortality on ECLS, or survival-to-discharge. The overall complication rate was slightly lower in the off-hours group (45.7 % versus 61.9 %, P = 0.034).
  
  
  CONCLUSIONS
  Outcomes were not significantly worse for patients undergoing ELCS cannulation during off-hours compared to normal weekday working hours.
authors.affiliation: Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA.
authors.forename: Katherine W
authors.initials: KW
authors.lastname: Gonzalez
authors.affiliation: Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA.
authors.forename: Brian G A
authors.initials: BG
authors.lastname: Dalton
authors.affiliation: Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA.
authors.forename: Katrina L
authors.initials: KL
authors.lastname: Weaver
authors.affiliation: Department of Statistics, Children's Mercy Hospital, Kansas, MO, USA.
authors.forename: Ashley K
authors.initials: AK
authors.lastname: Sherman
authors.affiliation: Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA.
authors.forename: Shawn D
authors.initials: SD
authors.lastname: St Peter
authors.affiliation: Department of Surgery, Children's Mercy Hospital, 2401 Gillham Road, Kansas, MO, 64108, USA. csnyder@cmh.edu.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Snyder
mesh_terms: D000293:Adolescent; D002404:Catheterization / Q000592:standards*; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000628:therapy*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D013997:Time Factors
keywords: Cannulation; Extracorporeal membrane oxygenation; Outcomes; Timing