217: Centrifugal Versus Roller Pumps in Pediatric Extracorporeal Membrane Oxygenation: Experiences from a Community Hospital

Purpose: To compare the clinical outcomes of centrifugal pumps to roller pumps in nurse-managed pediatric extracorporeal membrane oxygenation (ECMO) at a community hospital. Methods: A retrospective single-center study was conducted on all patients between 4-weeks old and 18-years old who received ECMO support in the PICU between December 1997 and March 2023. 41 ECMO runs were performed, of which 20 used centrifugal pumps (PediMag/CentriMag) and 21 used roller pumps (Stockert). The endpoints investigated include survival to discharge, ECMO duration, and ECMO complications. Analyses were performed using Fisher’s exact tests and two-tailed unpaired t-tests. Results: There were no statistically significant differences in survival to discharge when comparing centrifugal pumps to roller pumps in elective pulmonary support (p=0.619), elective cardiac support (p=0.608), and extracorporeal cardiopulmonary resuscitation (ECPR) (p=0.999). There were no significant differences in average ECMO duration for elective pulmonary support (206 vs. 226 hours, p=0.849), elective cardiac support (137 vs. 132 hours, p=0.885), and ECPR (94.3 vs. 98.1 hours, p=0.952). There were no significant differences in the average incidence of mechanical, hemorrhagic, neurologic, renal, cardiovascular, pulmonary, infectious, metabolic, and limb complications per patient; however, of the complications that arose, centrifugal pumps had a significantly higher rate of major complications (defined by ELSO guidelines) compared to roller pumps (32.8% vs. 4.26%, p=0.00478). Conclusion: Both centrifugal and roller pumps yielded similar patient outcomes; however, centrifugal pumps were associated with a higher rate of developing major complications. The results of this study encourage further exploration by larger-scale clinical investigations.