Clinical observation of extracorporeal membrane oxygenation in salvage treatment of fulminant Mycoplasma pneumoniae pneumonia in children
ZHOU Yiping
ZHANG Yucai
SHAN Yijun
CHEN Rongxin
SUN Ting
ZHU Guangyao
DOU Jiaying
CUI Yun
Abstract：Objective To analyze the clinical efficacy and safety of extracorporeal membrane oxygenation(ECMO)in salvage treatment for children with fulminant Mycoplasma pneumoniae pneumonia(FMPP).Methods A retrospective analysis was conducted on the clinical data of 14 pediatric patients with FMPP who were admitted to Department of Critical Care Medicine of Shanghai Children's Hospital and were treated with ECMO from January 2017 to December 2019.The pediatric patients'clinical data including general data,clinical and imaging features,initial parameters of mechanical ventilation and ECMO,complications and prognosis were summarized.Results The salvage treatment with ECMO was performed on the 14 FMPP pediatric patients,with a median age of 45 months.Among them,8 pediatric patients received veno-arterial ECMO(VA-ECMO)support,and 6 pediatric patients received veno-venous ECMO(VV-ECMO)support.Before ECMO,the median duration of fever was 12 days,and the median duration of mechanical ventilation was 65 hours.The median pre-ECMO oxygenation index(P/F)was 62 mmHg,and the median oxygenation index(OI)was 28.Before ECMO,the D-dimer levels in peripheral blood of all the pediatric patients were elevated,with a median value of 3.9 mg/L.The median running time of ECMO was 141 hours,and 11 pediatric patients underwent continuous renal replacement therapy.Five pediatric patients presented with ECMO-related complications,including 1 case of cerebral infarction,1 case of heavy bleeding at the gums due to tooth decay,1 case of membrane oxygenator and pipeline embolization and 2 cases of hemothorax.Among the 14 pediatric patients,9 pediatric patients had mixed infections.Among them,2 pediatric patients died of multiple organ failure due to complicating human adenovirus infection and secondary Acinetobacter baumannii infection,respectively.Conclusion ECMO is an effective means in salvage treatment of cardiopulmonary failure in children with FMPP.However,the adoption of ECMO can lead to a high incidence of complications such as bleeding and coagulation in the children,and the complicating infections may result in a poor prognosis for the FMPP children.
Keywords：Extracorporeal membrane oxygenation(ECMO)Fulminant Mycoplasma pneumoniae pneumonia(FMPP)Refractory hypoxemic respiratory failureChildren
Publication Date：2025-08-30
Online Publishing Date：2025-09-22(First online date of this platform, not the publication date of the document)
Pages：6( 842-847 )