Extracorporeal membrane oxygenation in the treatment of respiratory failure in pediatric patients with burns

J Burn Care Rehabil. 1998 Mar-Apr;19(2):131-4. doi: 10.1097/00004630-199803000-00009.


Extracorporeal membrane oxygenation (ECMO) as a treatment for pulmonary failure from postshock respiratory distress in burned children recently has been shown to salvage patients who were thought to have more than a 90% chance of dying. We describe five burned children in whom severe respiratory failure--not responsive to medical management and maximal ventilatory support--developed, and who underwent ECMO treatment. Three (60%) cases involved flame burns, with significant inhalation injury as diagnosed after a bronchoscopy; mean age was 3 years (2 to 4 years), with a mean total body surface area (TBSA) burn of 32% (15% to 53%), mean third-degree burns of 25% (5% to 53%). Two (40%) cases involved scald burns; mean age was 6 years (7 months to 11 years), with a mean TBSA burn of 56.5% (43% to 70%), mean third-degree burns of 40% (10.5% to 70%). Outcome was poor for those burned children who received ECMO therapy after prolonged ventilatory support for smoke inhalation injury. Children who experience perfusion/reperfusion shock injury to the lungs as a result of delayed resuscitation of scald burns may have an improved chance of survival with short courses of ECMO regardless of the burn size.

MeSH terms

  • Burns / complications*
  • Child
  • Child, Preschool
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Guidelines as Topic
  • Humans
  • Infant
  • Male
  • Respiration, Artificial
  • Respiratory Insufficiency / therapy*
  • Resuscitation
  • Survival Rate
  • Treatment Outcome