Predictors of outcome of severe respiratory syncytial virus-associated respiratory failure treated with extracorporeal membrane oxygenation

Objective: To examine the Extracorporeal Life Support Organization registry data base for all infants and children with respiratory syncytial virus-associated respiratory failure managed with extracorporeal life support, to delineate predictors of outcome. Design: Retrospective cohort study. Setting: Extracorporeal Life Support Organization data registry. Patients: All pediatric patients treated in the United States with extracorporeal life support for severe pediatric respiratory syncytial virus-associated respiratory failure reported to the registry, from 1982 through June 1992. Interventions: Venoarterial or venovenous extracorporeal life support. Measurements and main results: As of June 1992, fifty-three pediatric patients meeting study entry criteria were reported to the Pediatric Respiratory Failure Registry (n=412) as having received extracorporeal membrane oxygenation (ECMO) for severe respiratory syncytial virus infection with pulmonary failure. Forty-nine percent (26/53) were successfully managed and survived to hospital discharge. The mean patient age was 5.0±8.6 months. Duration of mechanical ventilation before institution of extracorporeal life support was 8.1±6.2 days. Multivariate logistic regression analysis found four variables to be associated with patient nonsurvival at the p