Effect of timing of cannulation on outcome for pediatric extracorporeal life support.
PURPOSE: Literature reports worse outcomes for operations performed during off-hours. As this has not been studied in pediatric extracorporeal life support (ECLS), we compared complications based on the timing of cannulation.
METHODS: This is a retrospective review of 176 pediatric ECLS patients between 2004 and 2015. Patients cannulated during daytime hours (7:00 A.M. to 7:00 P.M., M-F) were compared to off-hours (nighttime or weekend) using t-test and Chi-square.
RESULTS: The most common indications for ECLS were congenital diaphragmatic hernia (33 %) and persistent pulmonary hypertension (23 %). When comparing regular hours (40 %) to off-hours cannulation (60 %), there were no significant differences in central nervous system complications, hemorrhage (extra-cranial), cannula repositioning, conversion from venovenous to venoarterial, mortality on ECLS, or survival-to-discharge. The overall complication rate was slightly lower in the off-hours group (45.7 % versus 61.9 %, P = 0.034).
CONCLUSION: Outcomes were not significantly worse for patients undergoing ELCS cannulation during off-hours compared to normal weekday working hours.
Pediatric surgery international
Adolescent; Catheterization; Child; Child, Preschool; Congenital Abnormalities; Extracorporeal Membrane Oxygenation; Female; Humans; Infant; Infant, Newborn; Male; Retrospective Studies; Time Factors
Cannulation; Extracorporeal membrane oxygenation; Outcomes; Timing; ECMO; ECLS
Gonzalez, K. W., Dalton, B. G., Weaver, K. L., Sherman, A. K., St Peter, S. D., Snyder, C. L. Effect of timing of cannulation on outcome for pediatric extracorporeal life support. Pediatric surgery international 32, 665-669 (2016).