200: Health Related Quality of Life in Pediatric Cardiac ECLS Survivors: Is Alive Good Enough?

Extra Corporeal Life Support (ECLS) has evolved to a standard of care in many pediatric centers, with thousands of patients supported to date. There is a lack of studies examining long-term outcomes including health related quality of life (HRQL). We aim to assess the HRQL of children who received cardiac ECLS, and to compare them with a healthy sample, children with chronic conditions and children who had cardiac surgery and did not receive ECLS. Prospective cohort study including children <5 years of age with diagnosis of cardiac disease who received ECLS at the Stollery Children's Hospital between 1999 and 2009. HRQL was assessed using the PedsQLTM 4.0 Generic Core Scales. Analysis was performed with t-test for independent samples and multiple linear regression. Study approved by institutional health research ethics board. Ninety-eight patients received ECLS between 2000 and 2009, 50 (51%) survived and 47 children were assessed at a median age of four years. Children who received veno-arterial ECLS have significantly lower PedsQLTM 4.0 than healthy children (64.9 vs. 82.2; P<0.0001), children with chronic conditions (64.9 vs. 73.1; P=0.007), and children who underwent cardiac surgery and who did not receive ECLS (64.9 vs. 81.1; P<0.0001). Multiple linear regression analysis found an independent association between higher inotrope score in the first 24 h of ECLS, longer hospital length of stay and lower PedsQLTM 4.0 scores. Pediatric cardiac ECLS survivors showed lower HRQL than healthy children, children with chronic conditions and those with congenital heart disease who did not receive ECLS.