{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T19:52:16Z","timestamp":1791921136472,"version":"4.3.4"},"reference-count":19,"publisher":"Springer Science and Business Media LLC","issue":"10","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Pediatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Measles is resurgent worldwide, and although vaccine-preventable, severe disease can progress to cardiorespiratory failure refractory to conventional support. This study aimed to determine whether extracorporeal membrane oxygenation (ECMO) is feasible in children with measles. A retrospective case series at a tertiary pediatric intensive care unit (PICU) with a regional ECMO program, of all children younger than 18\u00a0years with laboratory-confirmed measles who received ECMO during the August 2025\u2013May 2026 outbreak. Of 49 children with measles admitted to the PICU, 10 received ECMO. Five were male; median age was 11\u00a0months (IQR, 10\u201324), and none had completed age-appropriate vaccination. Indications were septic shock or cardiorespiratory failure (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20095), acute respiratory distress syndrome with septic shock (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), hypoxemic respiratory failure (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), and suspected myocarditis (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091). Seven received venoarterial, 1 veno-venoarterial, and 2 venovenous ECMO. Bacteremia preceded ECMO in 5 children and positive sputum culture in 8.\n                    <jats:italic>Candida tropicalis<\/jats:italic>\n                    candidemia developed in 3 of the first 5 patients, with none among the subsequent 5 after antifungal prophylaxis at cannulation. Left ventricular dysfunction was present in 7 of 9 assessed, 4 required decompression, and neuroimaging was abnormal in 4 of 8 imaged. Six children (60%) survived to discharge.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:italic>Conclusions<\/jats:italic>\n                    :\u00a0ECMO was feasible and potentially lifesaving in measles-associated cardiorespiratory failure, with survival comparable to other high-acuity pediatric indications, but the course was complicated by bacterial and fungal coinfection, cardiac dysfunction, and neurologic injury. These resource-intensive presentations occurred exclusively in unvaccinated children and were preventable, underscoring measles vaccination coverage as a public health priority.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:table-wrap>\n                      <jats:table>\n                        <jats:tbody>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is Known:<\/jats:bold>\n                              \u2022\u00a0\n                              <jats:italic>Measles is resurgent worldwide and can cause severe respiratory, cardiac, and immune complications in children.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Measles-induced immune suppression predisposes to secondary bacterial and fungal infection.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                          <jats:tr>\n                            <jats:td colspan=\"2\">\n                              <jats:bold>What is New:<\/jats:bold>\n                              \u2022\n                              <jats:italic>First reported series of ECMO for measles: feasible, with 60% survival, but marked by coinfection, cardiac dysfunction, and neurologic injury.<\/jats:italic>\n                              \u2022\n                              <jats:italic>Antifungal prophylaxis at ECMO cannulation was associated with elimination of candidemia in this cohort.<\/jats:italic>\n                            <\/jats:td>\n                          <\/jats:tr>\n                        <\/jats:tbody>\n                      <\/jats:table>\n                    <\/jats:table-wrap>\n                  <\/jats:p>","DOI":"10.1007\/s00431-026-07467-4","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:41:15Z","timestamp":1790847675000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal membrane oxygenation for life-threatening measles in children: a case series"],"prefix":"10.1007","volume":"185","author":[{"given":"Salmas","family":"Watad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adi","family":"Avniel Aran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asaf","family":"Mandel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yshia","family":"Langer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ezra","family":"Weinblatt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isaac","family":"Manaster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Barsoum","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergei Elber","family":"Dorozko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dina","family":"Averbuch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oren","family":"Gordon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4575-3888","authenticated-orcid":false,"given":"Uri","family":"Pollak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"7467_CR1","doi-asserted-by":"publisher","first-page":"2490","DOI":"10.1016\/S0140-6736(17)31463-0","volume":"390","author":"WJ Moss","year":"2017","unstructured":"Moss WJ (2017) Measles. 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Approval was granted by the Hadassah Medical Center Institutional Review Board (approval no. HMO-0460\u201312).","order":1,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Ethical approval included a waiver of the requirement for informed consent to participate\/publish, granted by the Hadassah Medical Center Institutional Review Board in view of the retrospective design and use of deidentified data.","order":2,"name":"Ethics","label":"Consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"791"}}