Work

Impact of early hyperoxia on outcomes during neonatal and pediatric veno-arterial extracorporeal life support

Year: 2025

Type: article

Abstract: BACKGROUND: Hyperoxia induces oxidative stress and can exacerbate inflammatory response to Veno-Arterial Extracorporeal Life Support (VA-ECLS). This study aimed to evaluate the association between hyperoxia during VA-ECLS and morbidity, complications, and in-hospital mortality. METHODS: > 300 mmHg. The primary outcome was all-cause in-hospital mortality. Secondary outcomes included a composite measure of cardiovascular or renal complications, AKI, and change in Functional Status. RESULTS: Among 229 patients supported on VA-ECLS runs, 73.4% involved neonates. Median age and weight of the entire cohort were 2.5 months (IQR 0.3, 19.0), and 4.4 kg (IQR 3.2, 10.7), respectively. Cardiac indications accounted for 48.9% of cases. Hyperoxia occurred in 79% of patients and was more common in those requiring ECLS for cardiac indications. The overall in-hospital mortality rate was 45%, increasing to 64% in the severe hyperoxia cohort (p = 0.23). Severe hyperoxia was significantly associated with the composite outcome of cardiovascular or renal complications but not in-hospital mortality in multivariable analysis. No association was found between hyperoxia, AKI, and adverse functional outcomes. CONCLUSIONS: targets to minimize hyperoxia may improve outcomes for patients supported on VA-ECLS.

Source: Journal of ExtraCorporeal Technology

DOI: 10.1051/ject/2025057