119: Centrifugal or Roller Blood Pumps for Neonatal VV-ECMO: Extracorporeal Life Support Organization Database Comparison of Mortality and Morbidity Using a Multivariable Logistic Regression Model

Objective: This study investigates the association between the use of centrifugal and roller pumps and outcomes of neonatal patients supported with venovenous extracorporeal membrane oxygenation (VV-ECMO) using the Extracorporeal Life Support Organization (ELSO) Registry data between 2016-2020. Methods: Data from all neonates (≤ 28 days) supported with VV-ECMO and cannulated via right internal jugular vein using dual-lumen VV cannulas and polymethyl-pentene (PMP) membrane-oxygenators from all ECMO centers reporting to the ELSO-Registry between 2016 and 2020 were collected. In order to generate a homogenous dataset for analysis, only those cannulated via right-internal-jugular-venous-vein using dual-lumen VV-cannulas and-polymethyl-pentene (pmp) membrane-oxygenators are included in this study. Results: A total of 612 neonates (centrifugal, n = 340; conventional roller, n = 272) were included in-the-analysis. Using a multivariable-logistic-regression-model, centrifugal-pump use – as opposed to roller-pump use – was associated with lesser-odds-of-survival, OR 0.53 [95%CI 0.33 to 0.84], p < 0.008. Thrombosis and clots in the circuit components were also associated with lesser-odds-of-survival, OR 0.28 [95%CI 0.16 to 0.60], p <0.001. We failed to show that hemolysis was an independent variable for survival, OR 0.60 [95%CI 0.31 to 1.19], p = 0.14. The primary-diagnosis of neonatal aspiration/meconium-aspiration is associated with more than 7-fold greater odds-of-survival; OR 7.57 [95%CI 4.02 to 15.74], p < 0.001. Conclusions: Contrary to our hypotheses, conventional roller pump use was associated with greater-odds-of survival. While thrombosis and clots in circuit components were independent variables for lesser odds-of-survival, further research is needed better to understand the use of centrifugal pumps in neonatal practice.