Impact of extracorporeal membrane oxygenation in immunocompetent children with severe adenovirus pneumonia

Tingting Shi; Chen Chen; Huifeng Fan; Minghua Yu; Ming Li; Diyuan Yang; Li Huang; Zhiqiang Nie; Gen Lu

doi:10.1186/s12890-022-02284-5

Impact of extracorporeal membrane oxygenation in immunocompetent children with severe adenovirus pneumonia

BMC Pulm Med. 2023 Jan 30;23(1):41. doi: 10.1186/s12890-022-02284-5.

Authors

Tingting Shi^#¹, Chen Chen^#^{1

2}, Huifeng Fan¹, Minghua Yu³, Ming Li², Diyuan Yang¹, Li Huang², Zhiqiang Nie⁴, Gen Lu⁵

Affiliations

¹ Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120, Guangdong, China.
² Pediatric Intensive Care Unit, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
³ Department of Cardiology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
⁴ Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China. niezhiqiang@gdph.org.cn.
⁵ Department of Respiratory, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9, Jinsui Road, Zhujiang New City, Tianhe District, Guangzhou, 510120, Guangdong, China. lugen5663330@sina.com.

^# Contributed equally.

Abstract

Background: Severe adenovirus (Adv.) pneumonia can cause significant mortality in young children. There has been no worldwide consensus on the impact of extracorporeal membrane oxygenation (ECMO) in immunocompetent children with severe Adv. pneumonia. This study aimed to assess the impact of ECMO in immunocompetent children with severe Adv. pneumonia.

Methods: This study evaluated the medical records of 168 hospitalized children with severe Adv. pneumonia at the Guangzhou Women and Children's Medical Center between 2019 and 2020.Nineteen patients in the ECMO group and 149 patients in the non-ECMO group were enrolled.

Results: Between these two groups, there were no differences in host factors such as sex, age (all P > 0.05). Significant differences were observed in shortness of breath/increased work of breathing; cyanosis; seizures; tachycardia; the partial pressure of oxygen in arterial blood (PO₂); the ratio of PaO₂ to the fraction concentration of oxygen in inspired air (FiO₂; P/F); white blood cell, lymphocyte, monocytes, lactate dehydrogenase (LDH), serum albumin, and procalcitonin levels; and, pulmonary consolidation (all P < 0.05). There were significant differences in the parameters of mechanical ventilation (MV) therapy and complications such as respiratory failure, acute respiratory distress syndrome, septic shock, length of hospitalization, and death (all P < 0.05). The maximum axillary temperatures, respiratory rates, heart rates and LDH levels after receiving ECMO were significantly lower than those before ECMO (all P < 0.05). Additionally, SPO₂, PO₂, and P/F were significantly higher than those before ECMO (all P < 0.05). In MV therapy, FiO₂, PIP, and PEEP were significantly lower than those before ECMO (all P < 0.05).

Conclusions: In our study, the clinical conditions of the patients in the ECMO group were much more severe than those in the non-ECMO group. Our study showed that ECMO might be beneficial for the patients with severe Adv. pneumonia.

Keywords: Adenovirus; Children; Extracorporeal membrane oxygenation; Pneumonia; Severe.

MeSH terms

Adenoviridae
Adenoviridae Infections*
Child
Extracorporeal Membrane Oxygenation*
Humans
Oxygen
Pneumonia, Viral* / complications
Pneumonia, Viral* / therapy
Respiration, Artificial

Substances

Oxygen