Acute and Critical Care

Original Article

Epidemiology
Outcomes of extracorporeal membrane oxygenation support in pediatric hemato-oncology patients: Hong Yul An, Hyoung Jin Kang, June Dong Park; Acute Crit Care. 2024;39(1):108-116. Published online January 24, 2024; DOI: https://doi.org/10.4266/acc.2023.01088

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Background
In this study, we reviewed the outcomes of pediatric patients with malignancies who underwent hematopoietic stem cell transplantation (HSCT) and extracorporeal membrane oxygenation (ECMO).
Methods
We retrospectively analyzed the records of pediatric hemato-oncology patients treated with chemotherapy or HSCT and who received ECMO in the pediatric intensive care unit (PICU) at Seoul National University Children’s Hospital from January 2012 to December 2020.
Results
Over a 9-year period, 21 patients (14 males and 7 females) received ECMO at a single pediatric institute; 10 patients (48%) received veno-arterial (VA) ECMO for septic shock (n=5), acute respiratory distress syndrome (ARDS) (n=3), stress-induced myopathy (n=1), or hepatopulmonary syndrome (n=1); and 11 patients (52%) received veno-venous (VV) ECMO for ARDS due to pneumocystis pneumonia (n=1), air leak (n=3), influenza (n=1), pulmonary hemorrhage (n=1), or unknown etiology (n=5). All patients received chemotherapy; 9 received anthracycline drugs and 14 (67%) underwent HSCT. Thirteen patients (62%) were diagnosed with malignancies and 8 (38%) were diagnosed with non-malignant disease. Among the 21 patients, 6 (29%) survived ECMO in the PICU and 5 (24%) survived to hospital discharge. Among patients treated for septic shock, 3 of 5 patients (60%) who underwent ECMO and 5 of 10 patients (50%) who underwent VA ECMO survived. However, all the patients who underwent VA ECMO or VV ECMO for ARDS died.
Conclusions
ECMO is a feasible treatment option for respiratory or heart failure in pediatric patients receiving chemotherapy or undergoing HSCT.

Citations

Citations to this article as recorded by

Successful ECMO in an immunocompromised child with ALL, sepsis, and pneumonia
Radoslaw Jaworski, Anna Małecka, Jakub Brzeziński, Tomasz Lammek, Romuald Lango, Ninela Irga‐Jaworska
Pediatrics International.2026;[Epub] CrossRef
Extracorporeal Membrane Oxygenation in Pediatric Severe Aplastic Anemia: A Case Report Highlighting Risk-Benefit and Ethical Considerations
Abigail S Abraham, Merin M Mathew, Lyndsey Thomas, John Abraham, Madhura Butala
Cureus.2026;[Epub] CrossRef
Extracorporeal Membrane Oxygenation in the Management of Tumor Lysis Syndrome in Children: A Review of Cases
Zere Aidynbek, Erken Kakenov, Olga Mironova, Karlygash Ydyrysheva, Tatyana Li, Vitaliy Sazonov
Journal of Clinical Medicine.2025; 14(8): 2771. CrossRef
Successful venoarterial extracorporeal membrane oxygenation support for septic shock in a child with relapsed acute myeloid leukemia and complete superior vena cava obstruction: a case report
Bo Ram Kim, Hwa Jin Cho, Insu Choi, Hee Jo Baek, Hoon Kook, In Seok Jeong
Archives of Pediatric Critical Care.2025; 3(2): 89. CrossRef

Case Report

Neurology/Pulmonary
Extensive and Progressive Cerebral Infarction after Mycoplasma pneumoniae Infection: Yu Hyeon Choi, Hyung Joo Jeong, Bongjin Lee, Hong Yul An, Eui Jun Lee, June Dong Park; Korean J Crit Care Med. 2017;32(2):211-217. Published online December 29, 2016; DOI: https://doi.org/10.4266/kjccm.2016.00283

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204 Download
6 Web of Science
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Abstract PDF

Acute cerebral infarctions are rare in children; however they can occur as a complication of a Mycoplasma pneumoniae (MP) infection due to direct invasion, vasculitis, or a hypercoagulable state. We report on the case of a 5-year-old boy who had an extensive stroke in multiple cerebrovascular territories 10 days after the diagnosis of MP infection. Based on the suspicion that the cerebral infarction was associated with a macrolide-resistant MP infection, the patient was treated with levofloxacin, methyl-prednisolone, intravenous immunoglobulin, and enoxaparin. Despite this medical management, cerebral vascular narrowing progressed and a decompressive craniectomy became necessary for the patient’s survival. According to laboratory tests, brain magnetic resonance imaging, and clinical manifestations, the cerebral infarction in this case appeared to be due to the combined effects of hypercoagulability and cytokine-induced vascular inflammation.

Citations

Citations to this article as recorded by

High-Resolution Vessel Wall Imaging in Pediatric Mycoplasma Pneumoniae–Associated Central Nervous System Vasculitis
Mengyao Zhang, Xinju Li, Yanfeng Zhang
Pediatric Neurology.2026; 179: 133. CrossRef
Successful management of severe cerebral infarctions in a child with macrolide-resistant Mycoplasma pneumoniae: A case report
Min-Su Oh
Allergy, Asthma & Respiratory Disease.2025; 13(3): 129. CrossRef
Mycoplasma pneumoniae-associated cerebral infarction in a child: A case report and literature review
Quan Luo, Na Lu, Xia Wan, Fang Zheng, Xingxing Feng, Yan Bai
Medicine: Case Reports and Study Protocols.2025; 6(6): e00383. CrossRef
Was the occurrence of mycoplasma pneumoniae pneumonia combined with cerebral watershed infarction a coincidence?: A CARE compliant case series and literature review
Yuan-Yuan Wang, Jun-Ling Cui, Feng Mo, Ge-Fei Li
Medicine.2025; 104(50): e46541. CrossRef
Stroke associated with Mycoplasma hominis infection: a case report
Anthoula C. Tsolaki, Galaktion Konstantinidis, Stavroula Koukou, Fotini Michali, Despina Georgiadou, Thomas Tegos, Nikolaos D. Michalis
Journal of Medical Case Reports.2021;[Epub] CrossRef
Thrombosis associated with mycoplasma pneumoniae infection (Review)
Jingwei Liu, Yumei Li
Experimental and Therapeutic Medicine.2021;[Epub] CrossRef
Multiple anatomic sites of infarction in a pediatric patient with M. pneumoniae infection, a case report
Devon W. Hahn, Claire E. Atkinson, Matthew Le
BMC Pediatrics.2021;[Epub] CrossRef

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