PMID- 34264870
OWN - NLM
STAT- MEDLINE
DCOM- 20211213
LR  - 20230927
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 67
IP  - 12
DP  - 2021 Dec 1
TI  - Neurological Outcome According to the Site of Cannulation in Septic Children 
      Supported by Venoarterial Extracorporeal Membrane Oxygenation.
PG  - 1349-1355
LID - 10.1097/MAT.0000000000001532 [doi]
AB  - The impact of cervical cannulation on neurologic outcome has not been yet studied 
      among children receiving venoarterial extracorporeal membrane oxygenation 
      (VA-ECMO) in the context of severe sepsis or septic shock. A retrospective cohort 
      study was performed using the extracorporeal life support organization (ELSO) 
      registry. A total of 559 children weighing less than 20 kg with a primary or 
      secondary diagnosis of severe sepsis, septic shock or toxic shock syndrome were 
      included between January 1, 2010, and December 31, 2019. Cervical cannulation was 
      performed in 485 children (87%) and central cannulation in 74 children (13%). The 
      prevalence of acute neurologic event (ANE) was 32%, including clinical and/or 
      electroencephalographic seizures, cerebral infarction, cerebral hemorrhage, 
      and/or brain death. In multivariable analysis, we did not find an association 
      between cervical cannulation and greater/lesser odds of ANE during ECMO (adjusted 
      odds ratio [aOR] = 1.39, 95% confidence interval [CI] 0.72-2.65; P = 0.326). Only 
      pre-ECMO acidosis was independently associated with the development of ANE (pH < 
      6.99; aOR = 2.71, 95% CI 1.34-5.49; P = 0.006; pH 6.99 to <7.12; aOR = 2.57, 95% 
      CI 1.37-4.82; P = 0.003). Thus, the site of cannulation appears not as a 
      modifiable neurologic risk factor in this young septic population.
CI  - Copyright (c) ASAIO 2021.
FAU - Chenouard, Alexis
AU  - Chenouard A
AUID- ORCID: 0000-0003-4200-4838
AD  - From the Pediatric Intensive Care Unit.
FAU - Liet, Jean-Michel
AU  - Liet JM
AUID- ORCID: 0000-0002-4104-673
AD  - From the Pediatric Intensive Care Unit.
FAU - Maminirina, Pierre
AU  - Maminirina P
AD  - Pediatric Cardiac Surgery Unit, University Hospital, Nantes, France.
FAU - Denis, Manon
AU  - Denis M
AD  - From the Pediatric Intensive Care Unit.
FAU - Tonna, Joseph
AU  - Tonna J
AUID- ORCID: 0000-0001-8879-2628
AD  - Division of Cardiothoracic Surgery, University of Utah Health, Salt Lake City, 
      Uttah.
FAU - Rycus, Peter
AU  - Rycus P
AD  - Extracorporeal Life Support Organization (ELSO), Ann Arbor, Michigan.
FAU - Joram, Nicolas
AU  - Joram N
AD  - From the Pediatric Intensive Care Unit.
FAU - Bourgoin, Pierre
AU  - Bourgoin P
AUID- ORCID: 0000-0001-7713-8153
AD  - From the Pediatric Intensive Care Unit.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
SB  - IM
MH  - Catheterization/adverse effects
MH  - Child
MH  - *Extracorporeal Membrane Oxygenation/adverse effects
MH  - Humans
MH  - Retrospective Studies
MH  - *Sepsis/epidemiology/etiology
MH  - *Shock, Septic
COIS- Disclosure: P.R. is a member of the ELSO Executive Committee and J.T. is a member 
      of the ELSO Registry committee. The other authors have no conflicts of interest 
      to report.
EDAT- 2021/07/16 06:00
MHDA- 2021/12/15 06:00
CRDT- 2021/07/15 17:29
PHST- 2021/07/16 06:00 [pubmed]
PHST- 2021/12/15 06:00 [medline]
PHST- 2021/07/15 17:29 [entrez]
AID - 00002480-202112000-00012 [pii]
AID - 10.1097/MAT.0000000000001532 [doi]
PST - ppublish
SO  - ASAIO J. 2021 Dec 1;67(12):1349-1355. doi: 10.1097/MAT.0000000000001532.