title: Centrifugal pumps and hemolysis in pediatric extracorporeal membrane oxygenation (ECMO) patients: An analysis of Extracorporeal Life Support Organization (ELSO) registry data.
abstract: OBJECTIVE
  It is currently unclear whether centrifugal pumps cause more hemolysis than roller pumps in extracorporeal membrane oxygenation (ECMO) circuits. The aim of this study was to help answer that question in pediatric patients.
  
  
  METHODS
  A limited deidentified data set was extracted from the international multicenter Extracorporeal Life Support Organization (ELSO) registry comprising all reported ECMO runs for patients 18years or younger between 2010 and 2015. Logistic regression was used to evaluate a possible association between hemolysis and pump type, controlling for patient demographics, circuit factors, and complications.
  
  
  RESULTS
  14,776 ECMO runs for 14,026 patients had pump type recorded. Centrifugal pumps were employed in 60.4% of ECMO circuits. Hemolysis was a reported complication for 1272 (14%) centrifugal pump runs and for 291 (5%) roller pump runs. 1755 (20%) centrifugal pump runs reported kidney injury as compared to 797 (14%) roller pump runs. In the full logistic regression, the odds of hemolysis were significantly greater for runs using centrifugal pumps (OR 3.3, 95% CI 2.9-3.8, p<0.001).
  
  
  CONCLUSIONS
  In this retrospective analysis of a large international data set, the use of centrifugal pumps was associated with increased rates of hemolysis, hyperbilirubinemia, and kidney injury.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  Level III.
authors.affiliation: College of Physicians and Surgeons, Columbia University, New York, NY, United States.
authors.forename: Ciaran
authors.initials: C
authors.lastname: O'Brien
authors.affiliation: Department of Surgery, College of Physicians & Surgeons, Columbia University, New York, NY, United States.
authors.forename: Julie
authors.initials: J
authors.lastname: Monteagudo
authors.affiliation: Department of Surgery, College of Physicians & Surgeons, Columbia University, New York, NY, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Schad
authors.affiliation: Department of Pediatrics, Division of Critical Care Medicine, Columbia University, New York, NY, United States.
authors.forename: Eva
authors.initials: E
authors.lastname: Cheung
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, Columbia University College of Physicians and Surgeons and Morgan Stanley Children's Hospital of New York-Presbyterian, New York, NY, United States. Electronic address: wm61@cumc.columbia.edu.
authors.forename: William
authors.initials: W
authors.lastname: Middlesworth
mesh_terms: D000293:Adolescent; D002498:Centrifugation / Q000295:instrumentation; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects* / Q000295:instrumentation* / Q000379:methods; D005260:Female; D006461:Hemolysis; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors
keywords: ECMO; ELSO registry; Hemolysis; Pediatric