Table of Contents Author Guidelines Submit a Manuscript
Critical Care Research and Practice
Volume 2016, Article ID 9521091, 5 pages
http://dx.doi.org/10.1155/2016/9521091
Research Article

Identifying Prognostic Criteria for Survival after Resuscitation Assisted by Extracorporeal Membrane Oxygenation

1University of Geneva, Centre Medical Universitaire, 1 Rue Micheli-du-Crest, 1205 Geneva, Switzerland
2Pediatric Intensive Care Unit, Geneva University Hospital, 6 Rue Willy Donzé, 1205 Geneva, Switzerland

Received 29 November 2015; Revised 30 January 2016; Accepted 7 February 2016

Academic Editor: Antonio Artigas

Copyright © 2016 Alexandrine Brunner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

To improve survival rates during CPR, some patients are put on extracorporeal membrane oxygenation (ECMO). Among children who have undergone ECMO cardiopulmonary resuscitation (ECPR), the overall rate of survival to discharge is close to 40%. However, despite its wide acceptance and use, the appropriate indications and organizational requirements for ECPR have yet to be defined. Our objective was to assess the clinical outcomes of children after ECPR and to determine pre-ECPR prognostic factors for survival to guide its indication. Among the 19 patients who underwent ECPR between 2008 and 2014 in our center, 16 patients (84%, 95% confidence interval: 62–95%) died during their hospital stay, including nine (47%) who were on ECMO and seven (37%) after successful weaning from ECMO. All three survivors had normal cognitive status, but one child suffered from spastic quadriplegia. Survivors tended to have lower lactate, higher bicarbonate, and higher pH levels before ECMO initiation, as well as shorter length of resuscitation. In conclusion, in our center, ECPR has a poorer outcome than expected. Therefore, it might be important to identify, a priori, patients who might benefit from this treatment.