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Paediatric survivors of extracorporeal life support functional outcomes at one-year follow-up

Published online by Cambridge University Press:  30 September 2024

Meaghan A. Molloy Open the ORCID record for Meaghan A. Molloy [Opens in a new window] ,
Heather Viamonte ,
Jacob Calamaro ,
Cassidy Golden ,
Yijin Xiang ,
Joel Davis  and
Michael P. Fundora Open the ORCID record for Michael P. Fundora [Opens in a new window]
Meaghan A. Molloy
Affiliation:
Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
Heather Viamonte
Affiliation:
Department of Pediatrics, Children’s Healthcare of Atlanta Cardiology, Emory University School of Medicine, Atlanta, GA, USA Department of Pediatrics, Division of Critical Care, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
Jacob Calamaro
Affiliation:
School of Arts and Sciences, East Carolina University, Greenville, NC, USA
Cassidy Golden
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA
Yijin Xiang
Affiliation:
Department of Pediatrics, Children’s Healthcare of Atlanta, Emory University Pediatric Biostatistics Core, Atlanta, GA, USA
Joel Davis
Affiliation:
Department of Pediatrics, Division of Critical Care, Children’s Healthcare of Atlanta, Emory University School of Medicine, Atlanta, GA, USA
Michael P. Fundora*
Affiliation:
Department of Pediatrics, Children’s Healthcare of Atlanta Cardiology, Emory University School of Medicine, Atlanta, GA, USA
*
Corresponding author: Michael P. Fundora; Email: Michael.Fundora@emory.edu
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Abstract

Objective:

To investigate functional outcomes in children who survived extracorporeal life support at 12 months follow-up post-discharge.

Background:

Some patients who require extracorporeal life support acquire significant morbidity during their hospitalisation. The Functional Status Scale is a validated tool that allows quantification of paediatric function.

Methods:

A retrospective study that included children placed on extracorporeal life support at a quaternary children’s hospital between March 2020 and October 2021 and had follow-up encounter within 12 months post-discharge.

Results:

Forty-two patients met inclusion criteria: 33% female, 93% veno-arterial extracorporeal membrane oxygenation (VA ECMO), and 12% with single ventricle anatomy. Median age was 1.7 years (interquartile range 10 days–11.9 years). Median hospital stay was 51 days (interquartile range 34–91 days), and median extracorporeal life support duration was 94 hours (interquartile range 56–142 hours). The median Functional Status Scale at discharge was 8.0 (interquartile range 6.3–8.8). The mean change in Functional Status Scale from discharge to follow-up at 9 months (n = 37) was −0.8 [95% confidence interval (CI) −1.3 to −0.4, p < 0.001] and at 12 months (n = 34) was −1 (95% confidence interval −1.5 to −0.4, p < 0.001); the most improvement was in the feeding score. New morbidity (Functional Status Scale increase of ≥3) occurred in 10 children (24%) from admission to discharge. Children with new morbidity were more likely to be younger (p = 0.01), have an underlying genetic syndrome (p = 0.02), and demonstrate evidence of neurologic injury by electroencephalogram or imaging (p = 0.05).

Conclusions:

In survivors of extracorporeal life support, the Functional Status Scale improved from discharge to 12-month follow-up, with the most improvement demonstrated in the feeding score.

Keywords

extracorporeal life supportFunctional Status Scaleoutcomespaediatricpaediatric critical care
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 10 , October 2024 , pp. 2225 - 2230
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Copyright
© The Author(s), 2024. Published by Cambridge University Press

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