The long-term outcome of children managed with extracorporeal life support: an institutional experience
ABSTRACT
Objective: To evaluate the long-term functional status and quality of life of infants and children who have received extracorporeal life support (ECLS), and to determine how and when death occurred.
Design: Long-term, prospective follow-up study. Setting: 16-bed paediatric intensive care unit in a university teaching hospital. Participants: All children who received ECLS in the period April 1988 to October 2000 in the paediatric ICU at the Royal Children’s Hospital, Melbourne, VIC.
Methods: The records of all 224 children who had received ECLS were reviewed, and functional status and quality of life were assessed through interview with each child’s parent or guardian for those who had survived.
Results: Follow-up information was available for 211 children at a median of 7.2 years (range, 3.9 months to 12.6 years) after admission to the paediatric ICU. Sixty-nine children were alive at follow-up, 96% of whom were likely to lead an independent existence. Of the 142 deaths, 123 occurred in the paediatric ICU: 74 were due to elective withdrawal of therapy for poor prognosis, and eight for brain death; 30 were disease-related; seven were ECLSrelated; and four were due to sepsis.
Conclusions: ECLS is a complex therapy which has been used in Australian children for 18 years; a third of children survived long term, and 96% of these had a favourable outcome.
Crit Care Resusc 2007; 9:172–177
