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Extracorporeal life support for children with meningococcal septicaemia
Author(s) -
Luyt DK,
Pridgeon J,
Brown J,
Peek G,
Firmin R,
Pandya HC
Publication year - 2004
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2004.tb00851.x
Subject(s) - medicine , ards , extracorporeal membrane oxygenation , refractory (planetary science) , sepsis , respiratory distress , shock (circulatory) , surgery , pediatrics , intensive care medicine , lung , physics , astrobiology
Objective : To describe the short‐term outcome of children with meningococcal sepsis treated with extracorporeal membrane oxygenation (ECMO) in a single centre. Design : Retrospective analysis of case notes. Setting : The Heartlink ECMO Centre, Glenfield Hospital, Leicester. Patients : Eleven children (8 boys) out of a total caseload of 800 patients were treated for meningococcal sepsis with ECMO. Interventions : Extracorporeal membrane oxygenation. Results : All children with meningococcal sepsis treated with ECMO had a Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS) >12 (positive predictive risk of death of approximately 90%). Five children had adult respiratory distress syndrome (ARDS) and six had refractory shock with multi‐organ dysfunction syndrome (MODS) at presentation for ECMO. All five children in the ARDS group survived, four of five receiving veno‐venous (VV‐) ECMO therapy. In contrast, only one of six children with refractory shock with MODS survived, all of whom required veno‐arterial (VA‐) ECMO therapy. Conclusions: Most children with meningococcal sepsis and severe ARDS can be successfully treated with VV‐ECMO. In contrast, children with refractory shock and MODS die despite treatment with VA‐ECMO. This report does not resolve whether ECMO therapy offers any advantage over conventional therapy in treating severe meningococcal sepsis.