Extracorporeal Life Support in Pediatric Patients with Bronchopulmonary Dysplasia and Associated Pulmonary Hypertension

ASAIO J. Sep/Oct 2020;66(9):1063-1067. doi: 10.1097/MAT.0000000000001134.

Abstract

This retrospective study reviews outcomes of 281 pediatric patients with bronchopulmonary dysplasia (BPD) managed with extracorporeal life support (ECLS). Data from 1982 to 2018 from the Extracorporeal Life Support Organization (ELSO) registry were queried for children aged 60 days to 18 years with a prior diagnosis of BPD, and all patients with secondary pulmonary hypertension (PH) were identified. Overall survival of patients with and without PH was 86.7% and 68.0%, respectively (p = 0.23). There was no report of patients with PH before 2004. Patients with BPD + PH were more likely to have associated intraventricular hemorrhage (p = 0.002) and retinopathy of prematurity (p = 0.05), as well as a greater reported use of sildenafil (p = 0.0001) and milrinone (p = 0.008) before ECLS. The most common primary diagnosis in patients with BPD was viral respiratory infection (45.3%) and in patients with BPD + PH was respiratory failure without mention of infection (40.0%). Inotrope use was the most common complication reported (36.7%) with survival of 54.4%. We conclude that data from the ELSO registry demonstrate reasonable survival in both, patients with BPD and BPD + PH. Thus, patients with BPD and associated PH should be considered candidates for ECLS.

MeSH terms

  • Adolescent
  • Bronchopulmonary Dysplasia / complications
  • Bronchopulmonary Dysplasia / therapy*
  • Child
  • Cohort Studies
  • Extracorporeal Membrane Oxygenation / methods*
  • Female
  • Humans
  • Hypertension, Pulmonary / etiology
  • Infant
  • Infant, Newborn
  • Male
  • Retrospective Studies
  • Treatment Outcome