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 KW, Dalton BG, Weaver KL, Sherman AK, St Peter SD, Snyder CL. Effect of timing of cannulation on outcome for pediatric extracorporeal life support. Pediatr Surg Int. 2016;32(7):665-669. doi:10.1007/s00383-016-3901-6