Laparotomy complications on extracorporeal life support: Surgical site bleeding does not increase mortality

Space: StayCurrentMD Author: Wesley E Barry, Shannon L Castle, Jamie Golden, David M Rosenberg, Aaron R Jensen, David Bliss Published:

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Wesley E Barry, Shannon L Castle, Jamie Golden, David M Rosenberg, Aaron R Jensen, David Bliss

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Abstract

Purpose

The risks of laparotomy during extracorporeal life support (ECLS) are poorly defined. We examined risk factors associated with bleeding and mortality after laparotomy on ECLS.

Methods

The Extracorporeal Life Support Organization (ELSO) database was queried for all pediatric patients [0–17 years] with a procedure code for laparotomy. Outcome data were analyzed to define factors contributing to laparotomy complications and mortality while on ECLS. Univariate and multivariate analyses were applied to determine independent risk factors.

Results

196 patients who met inclusion criteria were identified. The mortality rate in the entire cohort was 67.3%. In both univariate and multivariate analyses, surgical site bleeding did not significantly increase the risk of mortality (OR 0.8; 95% CI 0.4–1.7). Logistic regression analysis revealed that lower gestational age, infectious complications and nonsurgical site hemorrhagic complications were independently increased mortality risk (all p 

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