Association of XXXX and @entity715 with outcome in extracorporeal life support.

@entity1 @entity932 @entity548 @entity2914 @entity683 @entity1167 @entity2142 @entity715 @entity204
OBJECTIVE: Changes in technology and increased reports of successful extracorporeal life support use in @entity1 populations, such as @entity683 , @entity1167 , and adults, are leading to expansion of extracorporeal life support. Major limitations to extracorporeal life support expansion remain @entity548 and @entity715 . These complications are the most frequent causes of @entity204 and morbidity. As a pilot project to provide baseline data for a detailed evaluation of @entity548 and @entity715 in the current era, extracorporeal life support @entity1 were analyzed from eight centers in the Eunice Kennedy Shriver National Institute of @entity1 Health and @entity1 Development Collaborative Pediatric Critical Care Research Network. STUDY DESIGN: Retrospective analysis of @entity1 (< 19 yr) reported to the Extracorporeal Life Support Organization registry from eight Collaborative Pediatric Critical Care Research Network centers between 2005 and 2011. SETTING: Tertiary @entity1 's hospitals within the Collaborative Pediatric Critical Care Research Network. SUBJECTS: The study cohort consisted of 2,036 @entity1 (13% with @entity2914 ). INTERVENTIONS: None. MAIN RESULTS: In the cohort of @entity1 without @entity2914 (n = 1,773), @entity548 occurred in 38% of @entity1 , whereas @entity715 was noted in 31%. Bleeding and @entity715 were associated with a decreased survival by 40% (relative risk, 0.59; 95% CI, 0.53-0.66) and 33% (odds ratio, 0.67; 95% CI, 0.60-0.74). Longer duration of extracorporeal life support and use of venoarterial cannulation were also associated with increased risk of @entity548 and/or @entity715 complications and lower survival. The most common @entity548 events included surgical site @entity548 (17%; n = 306), cannulation site @entity548 (14%; n = 256), and @entity932 (11%; n = 192). Common @entity715 events were clots in the circuit (15%; n = 274) and the oxygenator (12%; n = 212) and @entity2142 (plasma-free hemoglobin > 50 mg/dL) (10%; n = 177). Among @entity1 with @entity2914 , @entity548 and @entity715 occurred in, respectively, 45% (n = 118) and 60% (n = 159), Bleeding events were associated with reduced survival (relative risk, 0.62; 95% CI, 0.46-0.86) although @entity715 events were not (relative risk, 0.92; 95% CI, 0.67-1.26). CONCLUSIONS: Bleeding and @entity715 remain common complications in @entity1 undergoing extracorporeal life support. Further research to reduce or eliminate @entity548 and @entity715 is indicated to help improve @entity1 outcome.
