P0215 / #363: CLINICAL OUTCOMES OF PRIMARY AND SECONDARY PEDIATRIC ECLS TRANSPORT IN WESTERN CANADA

Abstract

Aims & Objectives: To describe extracorporeal life support (ECLS) transport by the Stollery Children’s Hospital Pediatric Transport Team (SCH-PTT) and to compare outcomes and complications of primary and secondary transports. Methods: Retrospective cohort study of all children transported on ECLS by the SCH-PTT between 2004-2018. We compared Primary (SCH- PTT performed ECLS cannulation and transport) vs. Secondary (cannulation performed by referring facility) transports, and those with and without an establish ECLS cannulation program (EECP). Results: SCH-PTT performed 68 ECLS transports during the study period. Median(IQR) age was 1.7(0.2-5) years. Median(IQR) transport distance was 298(298-1,209) kilometers. Indication for ECLS were: cardiac 28(41%), respiratory 26(38%) and sepsis 14(20.6%). Fifty-eight (85%) transports were Secondary. Mean(SD) times from referral call to ECLS-initiation were: Primary transports 7.8(2.9) vs. 2.5(3.5) hours for Secondary transports, p-value < 0.001. Fifty-one (75%) of the cannulations were done by an EECP. There was no significant difference in ECLS survival between Primary 9(90%) and Secondary transports 43(74%), p-value = 0.275. ECLS survival was higher for children cannulated by an EECP: 42(82%) vs. 10(59%), p-value = 0.048. There was no significant difference in hospital survival between Primary 9(90%) and Secondary transports 42(72%), p-value = 0.236. Hospital survival tended to be higher in children cannulated by an EECP: 41(80%) vs. 10(59%), p-value = 0.075. Complications were less frequent after ECLS initiation by EECP, p-value = 0.04. Conclusions: ECLS survival was higher for children cannulated by an EECP. We found no differences between Primary and Secondary transports. An EECP is likely more important than time from referral call to cannulation.