Table 3.
Characteristics of 108 patients <21 years with MIS-C or acute COVID-19 requiring ECMO support
| Clinical Characteristics | MIS-C ECMO (n=37) | Acute COVID-19 ECMO (n=71) |
|---|---|---|
| Type of ECMO, no. (%) | ||
|
| ||
| VV ECMO Only | 3 (8) | 42 (59) |
| VA ECMO Only | 33 (89) | 22 (31) |
| VV and VA ECMOa | 1 (3) | 7 (10) |
|
ECMO Course | ||
| Hospital Day of ECMO Start, median (IQR) | 1 (1, 2) | 5 (2, 10) |
| Total Length of ECMO (days), median (IQR) | 3.9 (2.6, 5.8) | 14 (6.1, 27.4) |
| Multiple ECMO Cannulations, no. (%) | 0 (0) | 5 (7) |
|
Reason for ECMO Initiation, no. (%) | ||
| Cardiac | 32 (87) | 16 (23) |
| Respiratory | 7 (19) | 58 (82) |
| Septic shock | 0 (0) | 1 (1) |
| ECPR | 7 (19) | 9 (13) |
|
Vasopressor Support at ECMO Initiation, median (IQR), no. (%) | ||
| Dopamine (µg/kg/min) | 12.5 (11.3, 13.8), n=2 (5) | 10 (10, 10), n=1 (1) |
|
| ||
| Dobutamine (µg/kg/min) | 8.25 (4.88, 11.63), n=2 (5) | N/A, n=0 (0) |
|
| ||
| Epinephrine (µg/kg/min) | 0.13 (0.09, 0.29), n=35 (95) | 0.1 (0.05, 0.18), n=34 (48) |
|
| ||
| Norepinephrine (µg/kg/min) | 0.24 (0.10, 0.38), n=18 (49) | 0.1 (0.05, 0.18), n=20 (28) |
|
| ||
| Milrinone (µg/kg/min) | 0.44 (0.25, 0.50), n=10 (27) | 0.28 (0.25, 0.50), n=8 (11) |
|
| ||
| Vasopressin (units/kg/h) | 0.07 (0.02, 0.84), n=10 (27) | 0.13 (0.05, 0.60), n=7 (10) |
|
Laboratory Values, median (IQR) | ||
| Pre-ECMO Lactate (mmol/L)b | 4.9 (3.4, 10.0) | 1.8 (1.1, 4.1) |
| Pre-ECMO Troponin (ng/mL)c | 0.84 (0.22, 5.68) | 0.05 (0.01, 1.10) |
| Highest Troponin (ng/mL)d | 0.92 (0.34, 8.0) | 0.42 (0.05, 5.42) |
|
Pre-ECMO Oxygenation | ||
| PaO2 (mmHg)e | 76 (59.3, 174) | 68 (58, 88.3) |
| FiO2f | 0.8 (0.5, 1.0) | 1.0 (0.73, 1.0) |
| PaCO2 (mmHg)g | 44 (36, 55) | 53.5 (45, 68.7) |
| pHh | 7.28 (7.20, 7.33) | 7.30 (7.18, 7.38) |
| Mean Airway Pressure (mmHg)i | 17 (14, 22.5) | 22.3 (17.5, 26.9) |
|
ECMO Discontinuation Reason, no. (%) | ||
| Recovery | 29 (78) | 43 (61) |
| Poor prognosis/redirection of goals of care | 3 (8) | 11 (16) |
| Death on ECMO | 5 (14) | 12 (17) |
| Bleeding complications | 0 (0) | 3 (4) |
| Transition to lung transplant eval | 0 (0) | 1 (1) |
| Transition to cardiac support* | 0 (0) | 1 (1) |
Abbreviations: COVID-19 = coronavirus disease 2019; MIS-C= Multisystem Inflammatory Syndrome in Children; IQR = interquartile range; ECMO = extracorporeal membrane oxygenation; No. = number; VV = veno-venous; VA = veno-arterial
Patient with underlying cardiomyopathy
MIS-C ECMO initial mode: VA, n=1 (3%); VV, n=0 (0%). Acute COVID-19 ECMO initial mode: VA, n=2 (3%); VV, n=5 (7%).
Available for 34 patients with MIS-C and 64 with acute COVID-19.
Available for 31 patients with MIS-C and 30 with acute COVID-19.
Available for 31 patients with MIS-C and 30 with acute COVID-19.
Available for 29 patients with MIS-C and 60 with acute COVID-19.
Available for 29 patients with MIS-C and 63 with acute COVID-19.
Available for 30 patients with MIS-C and 62 with acute COVID-19.
Available for 31 patients with MIS-C and 62 with acute COVID-19.
Available for 23 patients with MIS-C and 51 with acute COVID-19.