Extracorporeal life support for children with meningococcal septicaemia

D. K. Luyt, J. Pridgeon, J. Brown, G. Peek, R. Firmin, Hitesh C. Pandya

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1608-1611
Number of pages4
JournalActa Paediatrica, International Journal of Paediatrics
Volume93
Issue number12
DOIs
StatePublished - Dec 1 2004

Keywords

  • ARDS
  • ECMO
  • MODS
  • Meningococcus
  • Shock

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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