Prolonged extracorporeal membrane oxygenation in pediatric leukemia with severe acute respiratory distress syndrome and persistent fungemia

Kebudi, Rejin; Sözmen, Banu Oflaz; Bahar, Mois; Paker, Tufan; Hacı, İsmail; Ekinci, Alim; Egeli, Demet; Eren, Özge; Inel, Yalçın

doi:10.1002/pbc.28966

Cited by 2 publications

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“…In one study, ECMO was applied after bone marrow transplantation in patients with severe combined immunodeficiency [ 8 ], and in another study, ECMO was used in a patient with post-HSCT diffuse alveolar hemorrhaging [ 9 ]. In addition, ECMO has been used to treat tumor lysis syndrome, fungemia, and respiratory syncytial virus infection, all of which occur during the treatment of children with leukemia [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients

An,

Kang,

Park

2024

ACC

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Background: In this study, we reviewed the outcomes of pediatric patients with malignancies who underwent hematopoietic stem cell transplantation (HSCT) and extracorporeal membrane oxygenation (ECMO).Methods: We retrospectively analyzed the records of pediatric hemato-oncology patients treated with chemotherapy or HSCT and who received ECMO in the pediatric intensive care unit (PICU) at Seoul National University Children’s Hospital from January 2012 to December 2020.Results: Over a 9-year period, 21 patients (14 males and 7 females) received ECMO at a single pediatric institute; 10 patients (48%) received veno-arterial (VA) ECMO for septic shock (n=5), acute respiratory distress syndrome (ARDS) (n=3), stress-induced myopathy (n=1), or hepatopulmonary syndrome (n=1); and 11 patients (52%) received veno-venous (VV) ECMO for ARDS due to pneumocystis pneumonia (n=1), air leak (n=3), influenza (n=1), pulmonary hemorrhage (n=1), or unknown etiology (n=5). All patients received chemotherapy; 9 received anthracycline drugs and 14 (67%) underwent HSCT. Thirteen patients (62%) were diagnosed with malignancies and 8 (38%) were diagnosed with non-malignant disease. Among the 21 patients, 6 (29%) survived ECMO in the PICU and 5 (24%) survived to hospital discharge. Among patients treated for septic shock, 3 of 5 patients (60%) who underwent ECMO and 5 of 10 patients (50%) who underwent VA ECMO survived. However, all the patients who underwent VA ECMO or VV ECMO for ARDS died. Conclusions: ECMO is a feasible treatment option for respiratory or heart failure in pediatric patients receiving chemotherapy or undergoing HSCT.

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Section: Discussionmentioning

confidence: 99%

Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients

An,

Kang,

Park

2024

ACC

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“…After propensity score matching, there was no significant difference in the survival of patients receiving ECMO and those managed with mechanical ventilation only ( p = 0.089) ( 10 ). Only few cases reported the role of ECMO in pediatric patients with patient ( 16 , 17 ). The larger pediatric case series study on this topic is that Cortina et al ( 16 ) reported 9 patients of childhood leukemia with ARDS receiving ECMO, 5 (56%) patients survived to ECMO decannulationand4 (44%) survived to hospital discharge.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

et al. 2022

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ObjectiveThe cancer patients with severe acute respiratory distress syndrome (ARDS) benefit from extracorporeal membrane oxygenation (ECMO) remains unanswered. We analyzed clinical characteristics and outcomes of pediatric patients with leukemia/lymphoma who developed ARDS and treated with ECMO.MethodsPediatric leukemia or lymphoma patients with ARDS who underwent ECMO between August 2017 and December 2021 were retrospectively analyzed in a tertiary pediatric intensive care unit (PICU).ResultsSeven patients with median age 53 (IQR 42–117) months and 4 males were included. Six cases of leukemia [5 of acute lymphocytic leukemia (ALL) and 1 of acute myelogenous leukemia (AML, M5)] and 1 of non-Hodgkin lymphoma with severe ARDS received ECMO on chemotherapy period. The etiology of ARDS is community or chemotherapy-associated bacterial or/and fungal or viral infection. All the patients received chemotherapy in the 2 weeks prior to ECMO and five were neutropenic at initial ECMO. Six cases underwent veno-arterial ECMO (VA ECMO) and 1 for veno-venous ECMO (VV-ECMO). The median duration of ECMO support was 122 (IQR 56–166) hours. Overall, 42.9% (three of seven) survived to hospital discharge and 6 months survival rate was 28.6% (two of seven). Bleeding was the main ECMO-associated complication occurring in 7 patients, followed by nosocomial infection in 4 cases. All the patients required vasopressor support, and 6 received continuous renal replacement therapy (CRRT).ConclusionOur experiences suggest that rescue ECMO provides a selective treatment strategy in childhood hematologic malignancies with severe ARDS.

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Prolonged extracorporeal membrane oxygenation in pediatric leukemia with severe acute respiratory distress syndrome and persistent fungemia

Cited by 2 publications

References 15 publications

Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients

Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients

Extracorporeal membrane oxygenation for severe acute respiratory distress syndrome in children with leukemia/lymphoma: A retrospective case series

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