Long-Term Survival and Causes of Late Death in Children Treated With Extracorporeal Membrane Oxygenation.

OBJECTIVE

Extracorporeal membrane oxygenation has been used in patients with severe circulatory or respiratory failure since the 1970s, but the knowledge on long-term survival in this group is scarce. The aim of the present study was to investigate the 10-year survival rates and causes of late death in children treated with extracorporeal membrane oxygenation.

DESIGN

Single-center, retrospective cohort study.

SETTING

Tertiary referral center for extracorporeal life support.

PATIENTS

Neonatal and pediatric patients treated with extracorporeal membrane oxygenation from 1987 to December 2013.

INTERVENTIONS

None.

MEASUREMENTS AND MAIN RESULTS

Survival status was obtained from the national Causes of Death registry. Patient background data along with data on survival and causes of death were collected. Survival rates were calculated using the Kaplan-Meier method. Of 400 subjects, 76% survived to discharge. The median follow-up time in survivors was 7.2 years. There was a high mortality rate within the first months after discharge. In the group of patients who survived the first 90 days after treatment, the 10-year survival rates were 93% in neonates and 89% in pediatric patients and were particularly beneficial in patients whose indication for extracorporeal membrane oxygenation was meconium aspiration syndrome, trauma, or infectious diseases. Late deaths were seen in some diagnostic groups, but the Kaplan-Meier curves plateaued over time.

CONCLUSIONS

Children who survive the first months after treatment with extracorporeal membrane oxygenation have a high long-term survival rate. The prognosis is especially favorable in patients with reversible conditions.