Temporal Trends and Risk Factors for Bleeding and Thrombosis in Pediatric ECMO: A Multicenter Cohort study.

Document Type

Article

Publication Date

2025

Publication Title

Perfusion

Abstract

Introduction: Bleeding and thrombosis are major causes of morbidity and mortality in pediatric extracorporeal membrane oxygenation (ECMO), yet their evolving, time-dependent risks remain poorly defined. This study evaluated clinical predictors of bleeding and thrombotic events using time-to-event analysis.

Methods: A retrospective cohort study was conducted using the Pediatric ECMO Outcomes Registry (PEDECOR) from October 2011 to September 2024. Patients aged ≤18 years undergoing their first ECMO run were included. Two time-varying Cox proportional hazards models assessed associations between prior complications and time to first bleed or thrombosis, adjusting for clinical and ECMO-related variables.

Results: Among 1444 patients, median age was 0.4 years (IQR: 0.0-4.4), and 53.6% were male. Bleeding occurred in 65% and thrombosis in 28%. Time to first bleeding events had a median of 2 days (IQR: 0-4) while time to first thrombosis had a median of 3 days (IQR: 2-6). Prior thrombosis was associated with lower early bleeding risk (HR: 0.39, 95% CI: 0.25-0.62,

First Page

2676591251365417

Last Page

2676591251365417

Comments

Helen DeVos Children's Hospital

DOI

10.1177/02676591251365417

ISSN

1477-111X

PubMed ID

40741691

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