Julie Starck (Hôpital Armand-Trousseau), Marion Grimaud (Hôpital Necker-Enfants Malades), Elodie Salvador (Hôpital Necker-Enfants Malades), Angele Boet (Hôpital Antoine-Béclère), Simon Cressens (Centre Hospitalier Intercommunal André Grégoire, Montreuil), Mathieu Genuini (Hôpital Robert-Debré), Laure Maurice (Hôpital Robert-Debré), Erik Hervieux (Hôpital Armand-Trousseau), Margaux Pontailler (Hôpital Necker-Enfants Malades), Azzedine Ayachi (Hôpital Antoine-Béclère), Benoit Vivien (Hôpital Necker-Enfants Malades), Laurent Dupic (Hôpital Necker-Enfants Malades) Sabine Irtan (Hôpital Armand-Trousseau), Mehdi Oualha (Hôpital Necker-Enfants Malades), Pierre Louis Leger (Hôpital Armand-Trousseau), Jérome Rambaud (Hôpital Armand-Trousseau)
Purpose : Extracorporeal membrane oxygenation during cardiac arrest resuscitation is a life saving technology widely described for in hospital cardiac arrest in children with a cardiac underlying disease. However, only scarce data is available for out-of-hospital cardiac arrest in children.
Methods: We performed a multicenter retrospective analysis of all medical charts for out of ECMO center refractory cardiac arrests in children from January 2022 to June 2024. We analyzed medical chart from all refractory cardiac arrest in children between 0 days and 15 years old.
Results : Among 250 calls for cardiac arrest, 184 reached the definition of refractory arrest. Thirty-three were included in the regional program while the others did not reach the inclusion criteria. Seventeen arrived on time in the PICU and 13 were implanted on VA ECMO (4 ECMO implantation failure). Median age was 24.3 months (9.9 – 93.8). Length of low flow at first call was 25 minutes (18 – 40), length of cannulation was 30 minutes (20 – 42) and delay between the cardiac arrest and the ECMO running was 82 minutes (50 – 113). The survival rate was 6% (1/17). Four patients died from brain death without organ donation.
Conclusion : We described a large cohort of E-CPR for pediatric out of ECMO center refractory cardiac arrests. The results highlight a poor prognosis of out of ECMO center cardiac arrest despite solid regional organization. Considering these results, we decided to limit E-CPR indications to cardiac arrhythmia or accidental hypothermia.
pdf du preprint = Out_of_ECMO_center_refractory_cardiac_arrest