Neurologic and Functional Outcomes of Pediatric Extracorporeal Life Support: A 10-Year Study

Sunday, March 22, 2026

12:15 PM - 1:15 PM Central Time

Location: Connections Central - RST 17

Hirva Chudgar, MD (she/her/hers)

Memorial Health University Center, Georgia

Disclosure(s): No relevant financial relationship(s) to disclose.
Manzilat Akande, MD, MPH, MS (she/her/hers)

University of Oklahoma Health Sciences Center, Oklahoma

Disclosure information not submitted.
CJ

Christopher Jenks, MD, MS, FACC, FCCP

Associate Professor of Pediatrics, Section of Critical Care Medicine
University of Oklahoma Health Sciences Center

Disclosure information not submitted.
XL

Xiaolan Liao, Ph.D.

Assistant Professor
University of Oklahoma Health Sciences Center, Oklahoma

Disclosure information not submitted.
NS

Nicole Scholz, RN

Quality Coordinator
University of Oklahoma Health Sciences Center

Disclosure information not submitted.
LL

Laura Loftis, MD

Associate Professor of Pediatrics, Section of Critical Care Medicine
Texas Children's Hospital and Baylor College of Medicine

Disclosure information not submitted.
MM

Matthew P. Malone, MD

Associate Professor of Pediatrics, Division of Critical Care Medicine
University of Arkansas for Medical Sciences Arkansas Childrens Hospital

Disclosure information not submitted.
AS

Ahmed Said, MD, PhD

Assistant Professor of Pediatrics, Division of Critical Care Medicine
Institute of Informatics, Biostatistics and Data Science, Washington University, St. Louis School of Medicine

Disclosure information not submitted.
JF

Jamie Furlong-Dillard, DO

Assistant Professor
Norton Childrens Hospital

Disclosure information not submitted.
Melania M. Bembea, MD, MPH, PhD

Johns Hopkins University, Maryland

Disclosure information not submitted.
SB

Shelby Burk, BS, MS

Clinical Research Manager
Department of Pediatrics, Division of Critical Care Medicine, Stanford University School of Medicine

Disclosure information not submitted.
LR

Lindsey Rasmussen, MD

Clinical Associate Professor of Pediatrics, Division of Critical Care Medicine
Stanford University School of Medicine, California

Disclosure information not submitted.
BB

Brian Boville, MD

Associate Professor of Pediatrics, Division of Pediatric Critical Care Medicine
Helen DeVos Children’s Hospital

Disclosure information not submitted.
BN

Bridget Norton, MD, MBA

Pediatric Critical Care Medicine Physician
Arkansas Childrens Hospital

Disclosure information not submitted.
HV

Heather Viamonte, MD, MPH

Assistant Professor of Pediatrics, Divisions of Pediatric Critical Care and Cardiology
Children’s Healthcare of Atlanta and Emory University

Disclosure information not submitted.
MS

Marie Steiner, MD, MS

Professor of Pediatrics, Divisions of Hematology/Oncology and Critical Care
University of Minnesota Medical Center Fairview

Disclosure information not submitted.
SK

Santosh Kaipa, MD, MS

Assistant Professor of Pediatrics, Division of Critical Care
Children’s Nebraska and University of Nebraska Medical Center

Disclosure information not submitted.
MA

Matthew Amidon, DO

Assistant Professor of Pediatrics, Division of Critical Care Medicine
Medical College of Wisconsin

Disclosure information not submitted.
CA

Christine Allen, MD, MS

Associate Professor of Pediatrics, Section Chief for Pediatric Critical Care Medicine
University of Oklahoma Health Sciences Center

Disclosure information not submitted.

Introduction: Rates of extracorporeal life support (ECLS) for children with critical illness have doubled in the last decade. This increase has been associated with a significant burden of morbidity amongst ECLS survivors. Our objective was to identify demographic, clinical, and ECLS-related variables associated with favorable neurologic and functional outcomes in pediatric survivors of ECLS.

Methods: Multicenter retrospective cohort study utilizing the Pediatric ECMO Outcomes Registry (PEDECOR). Survivors of ECLS aged 30 days to 18 years across 10 years (2015-2024) were included. Neonates and those who received cardiopulmonary bypass were excluded. Favorable neurologic and functional outcomes were defined as a change in Pediatric Cerebral Performance Category (PCPC) score or Functional Status Score (FSS) of ≤2 or unchanged from baseline, respectively. Logistic regression models were used to assess the association between study variables and outcomes.

Results: Of 139 included patients, 94% had a favorable neurologic outcome and 66% had a favorable functional outcome. ECLS type was a nearly even distribution between Veno-arterial and Veno-venous (48% vs. 52%). Patients with longer median time to cannulation from intubation, primary diagnosis of infection, autoimmune, or multisystem disorder, age ≤ 2 years, and longer median time in the PICU after decannulation had significantly lower odds of favorable functional outcome in the unadjusted analysis (p < 0.05 for all). In the adjusted models, each additional day of ECLS was associated with 30% lower odds of a favorable functional outcome (p < 0.001). Patients who received ECLS for an infectious or autoimmune indication had 96% lower odds of a favorable functional outcome compared to those who received ECLS for a cardiovascular indication (p=0.012). The effect of ECLS duration on functional outcome was modified by age and history of a neurologic disorder. ECLS type was not significantly associated with functional outcome. No study variables were associated with a favorable neurologic outcome.

Conclusions: Among pediatric survivors of ECLS, we observed high rates of favorable neurologic and functional outcomes. Factors independently associated with a worse functional outcome were younger age and indications for ECLS due to infectious or autoimmune conditions.