Research Mentor Name

Elika Ridelman

Research Mentor Email Address

eridelma@dmc.org

Institution / Department

Wayne State University School of Medicine; Department of Surgery, Division of Pediatric Surgery, Children's Hospital of Michigan

Document Type

Research Abstract

Research Type

clinicalresearch

Graduate Level Research

no

Type of Post-Bachelor Degree

MD

Abstract

A Retrospective Study on the Associations of Clinical Measures to Mortality in Pediatric Extracorporeal Membrane Oxygenation (ECMO) Patients

Ammar Chauhdri; Ryan Davis, MD; Christina Shanti, MD; Michelle Veenstra, MD; Megan Zacarias; Samantha Carranza; Laura Sansoterra; Nimr Assaf; Christian Hudson-Bradford, MD; Elika Ridelman, PhD

Background: Extracorporeal membrane oxygenation (ECMO) is a form of temporary cardiopulmonary support used in critically ill pediatric patients when conventional therapies fail, yet survival to discharge remains only ~50% nationwide. Prior studies have identified candidate mortality predictors and developed basic risk scores, but these models have limited accuracy and are often derived from registry-level or narrowly defined cohorts, leaving gaps in understanding how specific management practices influence outcomes. We hypothesize that pediatric ECMO outcomes can be improved by identifying modifiable clinical factors, including but not limited to circuit flow parameters, anticoagulation strategies, and complication prevention. To our knowledge, this study represents one of the largest single-center pediatric ECMO cohorts with detailed clinical management data reported to date. Through this study, we aim to define predictors of mortality and characterize the impact of neurologic and cardiovascular complications on survival to better inform risk stratification and ECMO care protocols.

Methods: We are conducting a single-center retrospective cohort study of all pediatric patients who required venoarterial or venovenous ECMO at Children’s Hospital of Michigan between 2016 and 2025 (N=232). Trained medical students and physicians are manually abstracting data from the electronic medical record and perfusion records into a standardized database, beginning with demographics, diagnoses, ECMO indication and mode, cannulation characteristics, and major complications/interventions, followed by detailed anticoagulation parameters, transfusion data, hemodynamics, ventilator settings, and serial laboratory and coagulation values at prespecified time points. Planned analyses include descriptive statistics, univariate comparisons between survivors and non-survivors, and multivariable logistic regression to identify independent predictors of mortality and to explore temporal trends in outcomes over the study period.

Results: Data abstraction and cleaning are currently in progress. We anticipate having complete cohort characteristics and preliminary analyses of mortality, neurologic complications, and cardiovascular adverse events available by the time of presentation.

Conclusion: This study will leverage a decade of single-center pediatric ECMO experience to identify modifiable clinical and management factors associated with mortality and major neurologic and cardiovascular complications. By clarifying which variables most strongly predict poor outcomes, this work aims to refine risk stratification, inform institutional ECMO protocols, and lay the groundwork for future interventional strategies to improve survival and long-term outcomes in critically ill pediatric patients.

Disciplines

Cardiovascular System | Equipment and Supplies | Investigative Techniques | Medicine and Health Sciences | Other Analytical, Diagnostic and Therapeutic Techniques and Equipment | Respiratory System | Surgical Procedures, Operative | Therapeutics

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