EXTRACORPOREAL MEMBRANE-OXYGENATION IN THE TREATMENT OF RESPIRATORY-FAILURE IN PEDIATRIC-PATIENTS WITH BURNS

Extracorporeal membrane oxygenation (ECMO) as a treatment for pulmonar y failure from postshock respiratory distress in burned children recen tly has been shown to salvage patients who were thought to have more t han a 90% chance of dying. We describe five burned children in whom se vere respiratory failure-not responsive to medical management and maxi mal ventilatory support-developed, and who underwent ECMO treatment. T hree (60%) cases involved flame burns, with significant inhalation inj ury as diagnosed after a bronchoscopy; mean age was 3 years (2 to 4 ye ars), with a mean total body surface area (TBSA) burn of 32% (15% to 5 3%), mean third-degree burns of 25% (5% to 53%). Two (40%) cases invol ved scald burns; mean age was 6 years (7 months to 11 years), with a m ean TBSA burn of 56.5% (43% to 70%), mean third-degree burns of 40% (1 0.5% to 70%). Outcome was poor for those burned children who received ECMO therapy after prolonged ventilatory support for smoke inhalation injury. Children who experience perfusion/reperfusion shock injury to the lungs as a result of delayed resuscitation of scald burns may have an improved chance of survival with short courses of ECMO regardless of the burn size.