Evidence map›Paper›PMID 32252807›Full record

ArticleCritical care (London, England)2020

Long-term survival and costs following extracorporeal membrane oxygenation in critically ill children-a population-based cohort study.

Shannon M Fernando, Danial Qureshi, Peter Tanuseputro, Sonny Dhanani, Anne-Marie Guerguerian, Sam D Shemie, Robert Talarico, Eddy Fan, Laveena Munshi, Bram Rochwerg and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Critical care (London, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Cost-effectiveness of the timing of respiratory extracorporeal membrane oxygenation initiation in pediatric patients.Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo · 2026
    Article
  4. Observational
  5. Article
  6. Article
  7. Article
  8. Extracorporeal membrane oxygenation in children: A brief review.Journal of paediatrics and child health · 2022
    Review
  9. Article
  10. Review
  11. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 9 institutions in 2 countries.

Shannon M FernandoDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada. sfern014@uottawa.ca.
Danial QureshiICES, Toronto, ON, Canada.
Peter TanuseputroICES, Toronto, ON, Canada.
Sonny DhananiDepartment of Pediatrics, University of Ottawa, Ottawa, ON, Canada.
Anne-Marie GuerguerianInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Sam D ShemieDepartment of Pediatrics, McGill University, Montreal, QC, Canada.
Robert TalaricoClinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada.
Eddy FanInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Laveena MunshiInterdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, Canada.
Bram RochwergDepartment of Medicine, Division of Critical Care, McMaster University, Hamilton, ON, Canada.
Damon C ScalesICES, Toronto, ON, Canada.
Daniel BrodieDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Medicine, Columbia University College of Physicians and Surgeons and New York-Presbyterian Hospital, New York, NY, USA.
Kednapa ThavornICES, Toronto, ON, Canada.
Kwadwo KyeremantengDivision of Critical Care, Department of Medicine, University of Ottawa, Ottawa, ON, Canada.
University of Ottawa · CAUniversity of Toronto · CAOttawa Hospital · CAInstitut du Savoir Montfort · CAMcGill University · CAMcMaster University · CANewYork–Presbyterian Hospital · USOttawa Hospital Research InstituteUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundExtracorporeal membrane oxygenation (ECMO) is used to provide temporary cardiorespiratory support to critically ill children. While short-term outcomes and costs have been evaluated in this population, less is known regarding long-term survival and costs.

methodsPopulation-based cohort study from Ontario, Canada (October 1, 2009 to March 31, 2017), of pediatric patients (< 18 years of age) receiving ECMO, identified through the use of an ECMO procedural code. Outcomes were identified through linkage to provincial health databases. Primary outcome was survival, measured to hospital discharge, as well as at 1 year, 2 years, and 5 years following ECMO initiation. We evaluated total patient costs in the first year following ECMO.

resultsWe analyzed 342 pediatric patients. Mean age at ECMO initiation was 2.9 years (standard deviation [SD] = 5.0). Median time from hospital admission to ECMO initiation was 5 days (interquartile range [IQR] = 1-13 days). Overall survival to hospital discharge was 56.4%. Survival at 1 year, 2 years, and 5 years was 51.5%, 50.0%, and 42.1%, respectively. Among survivors, 99.5% were discharged home. Median total costs among all patients in the year following hospital admission were $147,957 (IQR $70,571-$300,295). Of these costs, the large proportion were attributable to the inpatient cost from the index admission (median $119,197, IQR $57,839-$250,675).

conclusionsChildren requiring ECMO continue to have a significant in-hospital mortality, but reassuringly, there is little decrease in long-term survival at 1 year. Median costs among all patients were substantial, but largely reflect inpatient hospital costs, rather than post-discharge outpatient costs. This information provides value to providers and health systems, allowing for prognostication of short- and long-term outcomes, as well as long-term healthcare-related expenses for pediatric ECMO survivors.

Indexed as

Health Care CostsHospital MortalityAdolescentChildChild, PreschoolCohort StudiesCritical IllnessExtracorporeal Membrane OxygenationFemaleHumansInfantMaleOntarioPatient DischargeAcute respiratory distress syndromeCardiac arrestCardiogenic shockECMOExtracorporeal membrane oxygenationHealth servicesPediatrics

Identifiers

PMID32252807
PMCPMC7137509
OpenAlexW3014856294

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.