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ECLS for Legionella

All Ages Welcome in the ELSO Registry

Dorfman, Molly V.; Clark, Jonna D.; Brogan, Thomas V.

doi: 10.1097/MAT.0000000000000985
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We describe the use of extracorporeal life support (ECLS) for Legionellosis in the pediatric and adult populations and report complications, morbidity, and mortality by conducting a retrospective review of patients from the Extracorporeal Life Support Organization registry, including two cases at our pediatric institution. A total of 194 patients with ECLS for Legionella pneumophila infection who received ECLS were included in the analysis. Overall survival was 71%. Lower body weight and VA ECLS were associated with lower survival. ECLS complications including CNS hemorrhage, cardiopulmonary resuscitation, pulmonary infection, and documented infections were rare but more common among nonsurvivors. Mortality in children (64%) was significantly higher than for adults (27%, p = 0.015). Infants fared very poorly with a mortality of 88%. As demonstrated, ECLS can successfully support patients with severe respiratory failure caused by L. pneumophila infection. Consideration should be given to its use in high-risk pediatric patients with severe acute hypoxemic respiratory failure of unclear etiology. ECLS is a beneficial tool for appropriate candidates with rare disease. Pulmonary respite may provide time for diagnosis and lung recuperation.

From the University of Washington/Seattle Children’s Hospital, Seattle, Washington.

Submitted for consideration June 2018; accepted for publication in revised form February 2019.

Disclosure: The authors have no conflicts of interest to report.

This work was performed at the Seattle Children’s Hospital, Seattle, WA.

Correspondence: Molly V. Dorfman, Pediatric Critical Care Medicine, Valley Children’s Hospital, 9300 Valley Children’s Pl, Madera, CA 93636. Email: mdorfman@valleychildrens.org.

Copyright © 2019 by the American Society for Artificial Internal Organs