Open AccessECLS for Legionella: All Ages Welcome in the ELSO Registry
Author(s) -
Molly V. Dorfman,
Jonna D. Clark,
Thomas V. Brogan
Publication year - 2020
Publication title -
asaio journal
Language(s) - English
Resource type - Journals
eISSN - 1538-943X
pISSN - 1058-2916
DOI - 10.1097/mat.0000000000000985
Subject(s) - medicine , extracorporeal , life support , respiratory failure , extracorporeal membrane oxygenation , etiology , intensive care medicine , mechanical ventilation , pediatrics , surgery
We describe the use of extracorporeal life support (ECLS) for Legionellosis in the pediatric and adult populations and report complications, morbidity, and mortality by conducting a retrospective review of patients from the Extracorporeal Life Support Organization registry, including two cases at our pediatric institution. A total of 194 patients with ECLS for Legionella pneumophila infection who received ECLS were included in the analysis. Overall survival was 71%. Lower body weight and VA ECLS were associated with lower survival. ECLS complications including central nervous system (CNS) hemorrhage, cardiopulmonary resuscitation, pulmonary infection, and documented infections were rare but more common among nonsurvivors. Mortality in children (64%) was significantly higher than for adults (27%, p = 0.015). Infants fared very poorly with a mortality of 88%. As demonstrated, ECLS can successfully support patients with severe respiratory failure caused by L. pneumophila infection. Consideration should be given to its use in high-risk pediatric patients with severe acute hypoxemic respiratory failure of unclear etiology. ECLS is a beneficial tool for appropriate candidates with rare disease. Pulmonary respite may provide time for diagnosis and lung recuperation.