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Research Snapshot Theater: Epidemiology - Outcomes, Pediatric III

Outcomes of Children Urgently Transferred From Pediatric ICUs to a Regional Pediatric ECMO Center

Sunday, March 22, 2026
12:15 PM - 1:15 PM Central Time
Location: Connections Central - RST 17

  • Christina L. Cifra, MD, MS

    Boston Children's Hospital

    Disclosure(s): De Gruyter Brill: Consultant (Ongoing)

  • RM

    Robin McKinney, MD

    Assistant Professor
    Hasbro Children's Hospital, Warren Alpert Medical School of Brown University

    Disclosure information not submitted.

  • IP

    Irene Pantekidis, BS

    Research Coordinator
    Boston Children's Hospital

    Disclosure information not submitted.

  • JT

    Joshua Ray Tanzer, PhD

    Research Scientist
    Brown University

    Disclosure information not submitted.

  • LA

    Laura G. Amar-Dolan, MD, MPH

    Pediatric Intensivist
    Maine Medical Center

    Disclosure information not submitted.

  • SB

    Suzanne Barry, DO

    Pediatric Intensivist
    Albany Medical Center

    Disclosure information not submitted.

  • KC

    Kelly L. Corbett, MD

    Assistant Professor
    Dartmouth Hitchcock Medical Center, Dartmouth Geisel School of Medicine

    Disclosure information not submitted.

  • LF

    Lauren E. Fortier, CPNP, MSN

    Nurse Practitioner
    UMass Memorial Medical Center

    Disclosure information not submitted.

  • AH

    Amelia J. Hopkins, MD

    Associate Professor
    University of Vermont Medical Center, The Robert Larner, MD College of Medicine at the University of Vermont

    Disclosure information not submitted.

  • CM

    Christine A. McKiernan, MD

    Assistant Professor
    Baystate Medical Center, UMass Chan Medical School Baystate

    Disclosure information not submitted.

  • RJ

    Rubina Jarkezian, N/A

    Research Assistant
    Boston Children's Hospital

    Disclosure information not submitted.

  • NL

    Nathan S. Levitties, N/A

    Research Assistant
    Boston Children's Hospital, Tufts University School of Medicine

    Disclosure information not submitted.

  • LT

    Lani Tran, N/A

    Research Assistant
    Boston Children's Hospital, Harvard College

    Disclosure information not submitted.

  • JR

    Jordan Rettig, MD

    Assistant Professor
    Boston Children's Hospital, Harvard Medical School

    Disclosure information not submitted.

  • MK

    Monica E. Kleinman, MD

    Associate Professor
    Boston Children's Hospital, Harvard Medical School

    Disclosure information not submitted.

  • Peta Alexander, MBBS, FRACP, FCICM

    Boston Children's Hospital, Massachusetts

    Disclosure information not submitted.

  • SV

    Sally H. Vitali, MD

    Assistant Professor
    Boston Children's Hospital, Harvard Medical School

    Disclosure information not submitted.

  • MA

    Michael SD Agus, MD

    Professor
    Boston Children's Hospital, Harvard Medical School

    Disclosure information not submitted.

  • SB

    Scot T. Bateman, MD

    Professor
    UMass Memorial Medical Center, University of Massachusetts Chan Medical School

    Disclosure information not submitted.

  • LP

    Lee Polikoff, MD, FCCM

    Associate Professor of Pediatrics
    Hasbro Children's Hospital

    Disclosure information not submitted.

Introduction: Pediatric extra-corporeal membrane oxygenation (ECMO) is an advanced therapy offered by few centers. Often, patients with severe cardiopulmonary failure undergo urgent transfer from pediatric intensive care units (PICUs) to an ECMO center for potential cannulation. Given the risks associated with ECMO and transport, it is crucial to identify patients most likely to benefit from transfer and ECMO support. Our objective was to determine the rates of and factors contributing to receipt of ECMO and survival of children urgently transferred to an ECMO center.


Methods: We performed a multicenter retrospective cohort study of patients 0-18 years referred by 5 PICUs to a pediatric ECMO center in the U.S. Northeast from 2013-2022. We excluded patients already on ECMO at referral and those referred for procedures needing ECMO back-up (not imminently requiring support). Patients’ records were linked across referring PICUs and the ECMO center. We collected demographic data, referral/transfer characteristics, clinical data at various timepoints, and patient outcomes.


Results: Preliminary results from completed reviews of 37 records showed that 36 (97%) referred patients were transferred to the ECMO center. One patient did not transfer due to clinical improvement. Mean referral time from PICU admission was 2.3 (SD 3.2) days and transfer occurred at a median of 6.5 (IQR 4.9, 8.6) hours from initial referral. Eight (22%) patients were cannulated onto ECMO at a median of 8.4 (IQR 4.4, 13.9) hours from ECMO center admission. Six (17%) patients died, all after transfer to the ECMO center, including 4 (50%) patients placed on ECMO. Unadjusted analysis showed that patients who received ECMO support were older (median 1.5 vs. 0.5 years), and at transfer, were more severely ill (median PRISM-III score 19.5 vs. 9) with greater life support needs (median OI 12.1 vs. 8.9 and median VIS 10 vs. 7.5).


Conclusions: In a regional pediatric ECMO referral network, 22% of referred patients subsequently received ECMO support, with a 17% mortality rate among all referred patients. Factors associated with ECMO cannulation will be determined using cluster analysis once data for the entire cohort is complete. Findings can potentially inform ECMO referral and transfer practices across a referral network.