Extracorporeal membrane oxygenation for respiratory failure in children: the years before and after the 2009 H1N1 pandemic.

Autor: Oliveira FRC; Unidade de Terapia Intensiva Pediátrica, Hospital Santa Catarina, São Paulo, São Paulo (SP), Brasil., Araujo OR; Unidade de Terapia Intensiva Pediátrica, Grupo de Apoio ao Adolescente e à Criança com Câncer, Instituto de Oncologia Pediátrica, Universidade Federal de São Paulo - São Paulo (SP), Brasil., Garros D; Unidade de Terapia Intensiva Pediátrica, Stollery Children's Hospital - Edmonton, Alberta, Canadá., Colleti Junior J; Unidade de Terapia Intensiva Pediátrica, Hospital Santa Catarina, São Paulo, São Paulo (SP), Brasil., Carvalho WB; Unidade de Terapia Intensiva Pediátrica, Hospital Santa Catarina, São Paulo, São Paulo (SP), Brasil., Lequier L; Unidade de Terapia Intensiva Pediátrica, Stollery Children's Hospital - Edmonton, Alberta, Canadá.
Jazyk: English; Portuguese
Zdroj: Revista Brasileira de terapia intensiva [Rev Bras Ter Intensiva] 2021 Oct-Dec; Vol. 33 (4), pp. 544-548. Date of Electronic Publication: 2022 Jan 24.
DOI: 10.5935/0103-507X.20210082
Abstrakt: Objective: To evaluate whether there was any impact on the number of pediatric extracorporeal membrane oxygenation runs and survival rates in the years subsequent to the 2009 pandemic.
Methods: We studied two different periods of extracorporeal membrane oxygenation support for respiratory failure in children by analyzing datasets from the Extracorporeal Life Support Organization. Autoregressive integrated moving average models were constructed to estimate the effect of the pandemic. The year 2009 was the year of intervention (the H1N1 epidemic) in an interrupted time series model. Data collected from 2001 - 2010 were considered preintervention, and data collected from 2010 - 2017 were considered postintervention.
Results: There was an increase in survival rates in the period 2010 - 2017 compared to 2001 - 2010 (p < 0.0001), with a significant improvement in survival when extracorporeal membrane oxygenation was performed for acute respiratory failure due to viral pneumonia. The autoregressive integrated moving average model shows an increase of 23 extracorporeal membrane oxygenation runs per year, prior to the point of the level effect (2009). In terms of survival, the preslope shows that there was no significant increase in survival rates before 2009 (p = 0.41), but the level effect was nearly significant after two years (p = 0.05), with a 6% increase in survival. In four years, there was an 8% (p = 0.03) increase in survival, and six years after 2009, there was up to a 10% (p = 0.026) increase in survival.
Conclusion: In the years following 2009, there was a significant, global incremental increase in the extracorporeal membrane oxygenation survival rates for all runs, mainly due to improvements in the technology and treatment protocols for acute respiratory failure related to viral pneumonia and other respiratory conditions.
Databáze: MEDLINE
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