Extracorporal life support for pulmonary hemorrhage in children: A case series

OBJECTIVE: To examine the use and outcome of extracorporeal life support in children with severe respiratory failure caused by pulmonary hemorrhage. DESIGN: Retrospective case series report. SETTING: Pediatric intensive care unit in a university children's hospital. PATIENTS: Eight patients <19 yrs of age who required extracorporeal life support for severe respiratory failure associated with pulmonary hemorrhage. INTERVENTIONS: Venoarterial or venovenous extracorporeal life support. MEASUREMENTS: Ventilatory support parameters and systemic PaO2/FiO2 ratio before extracorporeal life support, time on extracorporeal life support, number of ventilator days, number of intensive care unit days, number of hospital days, continued bleeding on extracorporeal life support, and survival. MAIN RESULTS: All patients had resolution of their pulmonary hemorrhage within 24 hrs. All patients survived to decannulation, extubation, and hospital discharge. All patients are alive, with follow-up times ranging from 1 to 10 yrs. CONCLUSIONS: Extracorporeal life support is not contraindicated in patients with severe respiratory failure with associated pulmonary hemorrhage and may be a life-sustaining supportive therapy.