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Open Access

Extracorporeal life support in pediatric trauma: a systematic review

Thaddeus Puzio, Patrick Murphy, Josh Gazzetta, Michael Phillips, Bryan A Cotton, Jennifer L Hartwell
DOI: 10.1136/tsaco-2019-000362 Published 13 September 2019
Thaddeus Puzio
1Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
2Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas, USA
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Patrick Murphy
1Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Josh Gazzetta
1Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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Michael Phillips
3Pediatric Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Bryan A Cotton
2Surgery, McGovern Medical School at the University of Texas Health Science Center, Houston, Texas, USA
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Jennifer L Hartwell
1Surgery, Indiana University School of Medicine, Indianapolis, Indiana, USA
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    Figure 1

    Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagram.

Tables

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  • Table 1

    Study quality

    /1/3/3/2/4/1/5/1/20
    AuthorObjectiveStudy designStudy populationInterventionOutcomesStatisticsResults/conclusionsCompeting interest/supportTotal
    Skarda et al11031313012
    Watson et al51131414015
    Fortenberry et al81031313012
    Steiner et al4100131208
    • A score of >14 indicates a study of adequate quality.

  • Table 2

    Characteristics of studies reporting on pediatric ECMO in trauma

    Author (year)Center, countryStudy designStudy periodSize (n)ECMO type
    Watson et al (2017)5Duke, USARetrospective cohort2007–201136NA
    Skarda et al (2012)1University of Utah, USACase series2010–201232 VA, 1 VV
    Fortenberry et al (2003)8Children's Healthcare of Atlanta, USACase series1991–200151 VA, 4 VV
    Steiner et al (1991)4Ochsner Clinic and Alton Ochsner Medical Foundation, Medical College of Virginia, University of Chicago, USACase seriesNA1414 VA
    • ECMO, extracorporeal membrane oxygenation; NA, not available; VA, venoarterial; VV, veno-venous.

  • Table 3

    Patient characteristics and outcomes of included studies

    Author (year)Age (years)Injury type, n (%)Surgery on ECMOECMO centerDays to cannulationIndication for cannulationSurvival, n (%)
    BluntPenetratingDrowning
    Watson et al (2017)5<1–1816 (44)6 (17)4 (11)NAAdult/pediatricNANA21 (58)
    Skarda et al (2012)18–172 (66)1 (33)–ICP monitor, ORIFPediatric<1–21ARDS, n=2
    Cardiovascular collapse, n=1
    3 (100)
    Fortenberry et al (2003)81–185 (100)––No, priorPediatric2–10ARDS, n=4
    Cardiovascular collapse, n=1
    4 (80)
    Steiner et al (1991)4NA6 (43)–8 (57)No, priorPediatricNAARDS, n=14
    Cardiovascular collapse, n=0
    7 (50)
    • ARDS, acute respiratory distress syndrome; ECMO, extracorporeal membrane oxygenation; ICP, intracranial pressure; NA, not available; ORIF, open reduction internal fixation.

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Extracorporeal life support in pediatric trauma: a systematic review
Thaddeus Puzio, Patrick Murphy, Josh Gazzetta, Michael Phillips, Bryan A Cotton, Jennifer L Hartwell
Trauma Surg Acute Care Open Sep 2019, 4 (1) e000362; DOI: 10.1136/tsaco-2019-000362

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Extracorporeal life support in pediatric trauma: a systematic review
Thaddeus Puzio, Patrick Murphy, Josh Gazzetta, Michael Phillips, Bryan A Cotton, Jennifer L Hartwell
Trauma Surg Acute Care Open Sep 2019, 4 (1) e000362; DOI: 10.1136/tsaco-2019-000362
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Extracorporeal life support in pediatric trauma: a systematic review
Thaddeus Puzio, Patrick Murphy, Josh Gazzetta, Michael Phillips, Bryan A Cotton, Jennifer L Hartwell
Trauma Surgery & Acute Care Open Sep 2019, 4 (1) e000362; DOI: 10.1136/tsaco-2019-000362
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