The Journal of ExtraCorporeal Technology No 57-3 | Seite 25

A. G. Beshish et al.: J Extra Corpor Technol 2025, 57, 129 – 136 135
increased mortality using a derived cut-point within our cohort. Our secondary aim was to determine if hyperoxia during VA-ECLS is associated with greater odds of morbidity using the Functional Status Scale( FSS), and the development of complications while on ECLS, including acute kidney injury( AKI). The study protocol conformed to the Declaration of Helsinki and was approved by the institution’ s ethics committee in Children’ s Healthcare of Atlanta, Atlanta, Georgia, USA. Medical research is subject to ethical standards that promote and ensure respect for all human subjects and protect their health and rights.
This study was approved by the Children’ s Healthcare of Atlanta Institutional Review Board: Study ID No.( IRB # 00001239), approved on 10 / 11 / 2022.
Supplementary material
The supplementary material is available at https:// ject. edpsciences. org / 10.1051 / ject / 2025006 / olm.
Supplemental Table 1. Cardiac Diagnosis of Patient in the VA-ECLS Cohort.
Supplemental Table 2. Patient Demographics and Clinical Characteristics of Patients Who Required VA-ECLS Post-Cardiotomy Stratified by Mean PaO 2 Levels in the First 48 h into Non-Hyperoxia Group( PaO 2 233 mmHg), Hyperoxia Group( PaO 2 > 233mmHg).
References
1. Munshi L, Kiss A, Cypel M, Keshavjee S, Ferguson ND, Fan E. Oxygen thresholds and mortality during extracorporeal life support in adult patients. Crit Care Med. 2017; 45( 12): 1997 – 2005.
2. Raffaeli G, Ghirardello S, Passera S, Mosca F, Cavallaro G. Oxidative stress and neonatal respiratory extracorporeal membrane oxygenation. Front Physiol. 2018; 9:1739.
3. ELSO. Registry of the extracorporeal life support organization. Ann Arbor ME: Registry Report; 2024.
4. Sznycer-Taub NR, Lowery R, Yu S, Owens ST, Hirsch- Romano JC, Owens GE. Hyperoxia is associated with poor outcomes in pediatric cardiac patients supported on venoarterial extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2016; 17( 4): 350 – 358.
5. Cashen K, Reeder R, Dalton HJ, et al. Hyperoxia and hypocapnia during pediatric extracorporeal membrane oxygenation: associations with complications, mortality, and functional status among survivors. Pediatr Crit Care Med. 2018; 19( 3): 245 – 253.
6. Ni YN, Wang YM, Liang BM, Liang ZA. The effect of hyperoxia on mortality in critically ill patients: a systematic review and meta analysis. BMC Pulm Med. 2019; 19( 1): 53.
7. Bonnemain J, Rusca M, Ltaief Z, et al. Hyperoxia during extracorporeal cardiopulmonary resuscitation for refractory cardiac arrest is associated with severe circulatory failure and increased mortality. BMC Cardiovasc Disord. 2021; 21( 1): 542.
8. Brown DM, Holt DW, Edwards JT, Burnett RJ. 3rd: Normoxia vs. hyperoxia: impact of oxygen tension strategies on outcomes for patients receiving cardiopulmonary bypass for routine cardiac surgical repair. J Extra Corpor Technol. 2006; 38( 3): 241 – 248.
9. Beshish AG, Jahadi O, Mello A, Yarlagadda VV, Shin AY, Kwiatkowski DM. Hyperoxia during cardiopulmonary bypass is associated with mortality in infants undergoing cardiac surgery. Pediatr Crit Care Med. 2021; 22( 5): 445 – 453.
10. Lilien TA, Groeneveld NS, van Etten-Jamaludin F, et al. Association of arterial hyperoxia with outcomes in critically Ill children: a systematic review and meta-analysis. JAMA Netw Open. 2022; 5( 1): e2142105.
11. Stoll SE, Paul E, Pilcher D, Udy A, Burrell A. Hyperoxia and mortality in conventional versus extracorporeal cardiopulmonary resuscitation. J Crit Care. 2022; 69:154001.
12. McDonald CI, Fraser JF, Coombes JS, Fung YL. Oxidative stress during extracorporeal circulation. Eur J Cardiothorac Surg. 2014; 46( 6): 937 – 943.
13. Al-Kawaz MN, Canner J, Caturegli G, et al. Duration of hyperoxia and neurologic outcomes in patients undergoing extracorporeal membrane oxygenation. Crit Care Med. 2021; 49( 10): e968 – e977.
14. Chang WT, Wang CH, Lai CH, et al. Optimal arterial blood oxygen tension in the early postresuscitation phase of extracorporeal cardiopulmonary resuscitation: A 15-year retrospective observational study. Crit Care Med. 2019; 47( 11): 1549 – 1556.
15. Kilgannon JH, Jones AE, Parrillo JE, et al. Relationship between supranormal oxygen tension and outcome after resuscitation from cardiac arrest. Circulation. 2011; 123( 23): 2717 – 2722.
16. Page D, Ablordeppey E, Wessman BT, et al. Emergency department hyperoxia is associated with increased mortality in mechanically ventilated patients: a cohort study. Crit Care. 2018; 22( 1): 9.
17. Davis DP, Meade W, Sise MJ, et al. Both hypoxemia and extreme hyperoxemia may be detrimental in patients with severe traumatic brain injury. J Neurotrauma. 2009; 26( 12): 2217 – 2223.
18. Stevens PE, Levin A. Evaluation and management of chronic kidney disease: synopsis of the kidney disease: improving global outcomes 2012 clinical practice guideline. Ann Intern Med. 2013; 158( 11): 825 – 830.
19. Pollack MM, Holubkov R, Glass P, et al. Functional Status Scale: new pediatric outcome measure. Pediatrics. 2009; 124( 1): e18 – e28.
20. Berg RA, Nadkarni VM, Clark AE, et al. Incidence and outcomes of cardiopulmonary resuscitation in PICUs. Crit Care Med. 2016; 44( 4): 798 – 808.
21. Beshish AG, Baginski MR, Johnson TJ, Deatrick BK, Barbaro RP, Owens GE. Functional status change among children with extracorporeal membrane oxygenation to support cardiopulmonary resuscitation in a pediatric cardiac ICU: a single institution report. Pediatr Crit Care Med. 2018; 19( 7): 665 – 671.
22. Beshish AG, Rodriguez Z, Hani Farhat M, et al. Functional status change among infants, children, and adolescents following extracorporeal life support: a multicenter report. ASAIO J. 2022; 69( 1): 114 – 121.
23. Han B, Yang JK, Ling AY, et al. Early functional status after surgery for congenital heart disease: a single-center retrospective study. Pediatr Crit Care Med. 2021; 23( 2): 109 – 117.
24. Pollack MM, Holubkov R, Funai T, et al. Relationship between the functional status scale and the pediatric overall performance category and pediatric cerebral performance category scales. JAMA Pediatr. 2014; 168( 7): 671 – 676.
25. Elmer J, Scutella M, Pullalarevu R, et al. The association between hyperoxia and patient outcomes after cardiac arrest: analysis of a high-resolution database. Intensive Care Med. 2015; 41( 1): 49 – 57.
26. Klinger G, Beyene J, Shah P, Perlman M. Do hyperoxaemia and hypocapnia add to the risk of brain injury after intrapartum asphyxia? Arch Dis Child Fetal Neonatal Ed. 2005; 90( 1): 49 – 52.