Extracorporeal membrane oxygenation in pediatric septic shock: A single-center experience in Chile

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dc.contributor.authorGodoy, Loreto
dc.contributor.authorYunge, Mauricio
dc.contributor.authorRufs, Jorge
dc.contributor.authorGatica, Alejandra
dc.contributor.authorMuñoz, Carlos
dc.contributor.authorValverde, Cristian
dc.coverage.spatialItalia
dc.date.accessioned2026-04-21T20:56:45Z
dc.date.available2026-04-21T20:56:45Z
dc.date.issued2026-01
dc.description.abstractBackground: Refractory septic shock (RSS) in children carries high mortality despite advances in critical care. Extracorporeal membrane oxygenation (ECMO) is a rescue therapy when conventional management fails. Evidence from Latin America remains limited, with no detailed reports from Chile. Methods: We conducted a retrospective single-center study (2009–2024) in a Chilean Pediatric ICU. Patients aged 1 month to 17 years with septic shock unresponsive to maximal conventional therapy were included. We analyzed demographics, illness severity, ECMO modality, complications, and outcomes. Primary endpoint was survival to hospital discharge. Results: Nine patients received ECMO (median age=6.3 years). All had RSS, frequently associated with severe ARDS. Configurations included venoarterial (VA; n=4), venovenous (VV; n=4), and venoarteriovenous (VAV; n=1), all via peripheral cannulation. Pre-ECMO median vasoactive-inotropic score was 117, and 78% required renal replacement therapy during ECMO. Overall survival was 55% (5/9). Survivors had longer ECMO runs (median 11 days vs 3 days) and ICU stays (median 63 days vs 5 days). Hemorrhage was the most frequent complication (intracranial n=3; gastrointestinal n=1). One survivor developed hemiparesis; no cognitive impairment was observed at 1-year follow-up. Conclusions: ECMO can be an effective rescue therapy for pediatric RSS, even without central cannulation capability. Distinguishing cardiogenic from vasoplegic phenotypes and identifying severe ARDS guided configuration selection (VA vs VV). These findings highlight the feasibility of peripheral ECMO in carefully selected patients within resource-limited settings, achieving survival comparable to international reports.
dc.identifier.citationThe International Journal of Artificial Organs, Vol. 49, N°.1 (2025) pp. 17-22
dc.identifier.doihttps://doi.org/10.1177/03913988251409039
dc.identifier.issn0391-3988
dc.identifier.issne1724-6040
dc.identifier.orcidhttps://orcid.org/0009-0005-3800-2348
dc.identifier.urihttps://hdl.handle.net/20.500.12254/7587
dc.language.isoen
dc.publisherSAGE Publications
dc.rightsAtribución-NoComercial-CompartirIgual 3.0 Chile (CC BY-NC-SA 3.0 CL)
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/3.0/cl/
dc.subjectPediatric septic shock
dc.subjectExtracorporeal membrane oxygenation
dc.subjectLatin America
dc.subjectVenoarterial ECMO
dc.subjectVenovenous ECMO
dc.subjectPeripheral cannulation
dc.subjectRefractory shock
dc.titleExtracorporeal membrane oxygenation in pediatric septic shock: A single-center experience in Chile
dc.typeArticle
dcterms.accessRightsEl artículo completo no puede ser publicado en el Repositorio Institucional debido a los permisos de copyright definidos por la editorial publicadora. Ingrese a través del DOI.
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