Abstract P-109: CLINICAL EXPERIENCES OF ECMO FOR ACUTE RESPIRATUAR DISTRESS SYNDROME IN CHILDREN

Aims & Objectives: To describe the experiences with venous-venous ECMO (VV-ECMO) for pediatric acute respiratory distress syndrome (ARDS) in a developing country. Methods Retrospective chart review of all pediatric patients receiving VV-ECMO from December 2016 to April 2017 in the pediatric intensive care unit (PICU) in Ankara University. Results Five pediatric patients (1 M/4 F) received VV-ECMO for ARDS. Mean value of the patients’ age and weight were 7.5 (2–13) months and 6.4 (2.7–10) kg, respectively. Indications of VV-ECMO were ARDS associated with viral pneumonia (3 respiratory syncytial virus, 1 human metapneumovirus) and postoperative pulmonary edema. Median of PRISM and PELOD were 25 (19–29) and 11 (10–11). The median of PaO2/FiO2, and oxygenation index (OI) were 47 (19–66), and 40 (40–59). The duration of intubation prior to ECMO was 3 (0–7) days, and median of positive end-expiratory pressure was 8 (8–10) mmHg. The median level of vasoactive-inotropic score was 15 (0–54). Prior to ECMO, prone position to one patient, and surfactant treatment to three patients were applied. Most frequent complications of ECMO were thrombocytopenia and transfusion need. Continuous renal replacement therapy was applied to 2 patients. VV-ECMO, and PICU hospitalization duration median values were 7 (3–17), and 30 (7–43) days. Survival to discharge was 80%. Conclusions VV-ECMO is a very risky therapy that offers a chance for children with ARDS who do not respond to conventional treatments to survive. For successful outcomes, careful intensive care follow-up by an experienced team is very important.