Functional Status Change in Pediatric Extracorporeal Membrane Oxygenation Survivors is Equivalent to Propensity-Matched Patients Managed Without Extracorporeal Membrane Oxygenation

Extracorporeal membrane oxygenation (ECMO) is now commonly used to manage refractory pediatric cardiac or respiratory failure. Traditionally, ECMO has been associated with high morbidity. However, despite advancements in ECMO techniques, little has been reported about the improvement of ECMO survivors' functional status. In this single-center retrospective case-control study, we compared noncardiac ECMO patients and propensity-score-matched controls' functional outcomes using the functional status score (FSS). Our main outcome of interest was the change of FSS between admission and discharge, using a threshold of FSS change greater than or equal to 3 or those who crossed between two functional groups as a clinically significant change. Eighty-one patients were paired in the ECMO versus non-ECMO survivors. At discharge, we found the difference between the median FSS scores of the cohort not statistically significant (10 vs. 8, p = 0.95). Similarly, using our predetermined cut-off of FSS change of greater than or equal to 3 or those crossing two functional groups, we found no difference between the two cohorts (odds ratio [OR]: 1.9, p = 0.052, OR: 1.71, p = 0.15). Our findings suggest that functional outcomes of noncardiac ECMO survivors may be comparable to those of patients managed without ECMO.