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Pediatric Extracorporeal Membrane Oxygenation in Korea: A Multicenter Retrospective Study on Utilization and Outcomes Spanning Over a Decade

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Author(s)
Yu Hyeon ChoiWon Kyoung JhangSeong Jong ParkHee Joung ChoiMin-Su OhJung Eun KwonBeom Joon KimJu Ae ShinIn Kyung LeeJune Dong ParkBongjin LeeHyun ChungJae Yoon NaAh Young ChoiJoongbum ChoJaeyoung ChoiHwa Jin ChoAh Young KimYu Rim ShinJoung-Hee ByunYounga Kim
Keimyung Author(s)
Choi, Hee Joung
Department
Dept. of Pediatrics (소아청소년학)
Journal Title
J Korean Med Sci
Issued Date
2024
Volume
39
Issue
3
Keyword
Extracorporeal Membrane OxygenationPediatricNeonatesChildrenSurvival Rate
Abstract
Background:
Over the last decade, extracorporeal membrane oxygenation (ECMO) use in critically ill children has increased and is associated with favorable outcomes. Our study aims to evaluate the current status of pediatric ECMO in Korea, with a specific focus on its volume and changes in survival rates based on diagnostic indications.

Methods:
This multicenter study retrospectively analyzed the indications and outcomes of pediatric ECMO over 10 years in patients at 14 hospitals in Korea from January 2012 to December 2021. Four diagnostic categories (neonatal respiratory, pediatric respiratory, post-cardiotomy, and cardiac-medical) and trends were compared between periods 1 (2012-2016) and 2 (2017-2021).

Results:
Overall, 1065 ECMO runs were performed on 1032 patients, with the annual number of cases remaining unchanged over the 10 years. ECMO was most frequently used for post-cardiotomy (42.4%), cardiac-medical (31.8%), pediatric respiratory (17.5%), and neonatal respiratory (8.2%) cases. A 3.7% increase and 6.1% decrease in pediatric respiratory and post-cardiotomy cases, respectively, were noted between periods 1 and 2. Among the four groups, the cardiac-medical group had the highest survival rate (51.2%), followed by the pediatric respiratory (46.4%), post-cardiotomy (36.5%), and neonatal respiratory (29.4%) groups. A consistent improvement was noted in patient survival over the 10 years, with a significant increase between the two periods from 38.2% to 47.1% (P = 0.004). Improvement in survival was evident in post-cardiotomy cases (30-45%, P = 0.002). Significant associations with mortality were observed in neonates, patients requiring dialysis, and those treated with extracorporeal cardiopulmonary resuscitation (P < 0.001). In pediatric respiratory ECMO, immunocompromised patients also showed a significant correlation with mortality (P < 0.001).

Conclusion:
Pediatric ECMO demonstrated a steady increase in overall survival in Korea; however, further efforts are needed since the outcomes remain suboptimal compared with global outcomes.
Keimyung Author(s)(Kor)
최희정
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1598-6357
Source
https://jkms.org/DOIx.php?id=10.3346/jkms.2024.39.e33
DOI
10.3346/jkms.2024.39.e33
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45333
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Pediatrics (소아청소년학)
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