{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T09:27:02Z","timestamp":1789032422562,"version":"build-2803163510"},"reference-count":14,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Veno\u2010arterial extracorporeal membrane oxygenation (V\u2010A ECMO) is increasingly utilized in pediatric patients. Failure to recognize membrane oxygenator failure can lead to critical complications due to rapid deterioration of membrane oxygenator function. Therefore, identifying the predictors for membrane oxygenator exchange is crucial. However, risk factors for membrane oxygenator exchange in pediatric V\u2010A ECMO remain unclear; therefore, this study aimed to evaluate these risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective cohort study enrolled all pediatric patients aged &lt;18\u2009years who received V\u2010A ECMO between August 2018 and July 2023 at a tertiary\u2010care pediatric hospital in Japan. The Cox proportional hazards model was used to evaluate the predictors of membrane oxygenator failure within 72\u2009h after initiation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, membrane oxygenator failure occurred in 18\/55 (32.7%) children within 72\u2009h; membrane oxygenator failure within 72\u2009h occurred in 4\/29 (13.8%) and 14\/26 (53.8%) in the groups with ratio of blood flow divided by the blood flow limit of the membrane oxygenator (B\/L) of &lt;0.5 and \u22650.5, respectively (adjusted hazards ratio, 4.97 [95% confidence interval, 1.33\u201318.5]; <jats:italic>p<\/jats:italic>\u2009=\u20090.017). After adjusting for delta pressure of the oxygenator, an increase in body weight and aspartate aminotransferase levels were associated with an increase in early membrane oxygenator failure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This retrospective study demonstrated that a B\/L ratio\u2009&gt;0.5, an increase in body weight, and elevated aspartate aminotransferase were independent risk factors for early membrane oxygenator failure in pediatric V\u2010A ECMO. However, a prospective multicenter study with an appropriate sample size is warranted to mitigate potential bias, and enhance generalizability for further investigation of the association between a B\/L ratio and early membrane oxygenator failure.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14826","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T10:58:40Z","timestamp":1721041120000},"page":"1346-1354","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Predictors of membrane oxygenator failure in pediatric extracorporeal membrane oxygenation"],"prefix":"10.1111","volume":"48","author":[{"given":"Makoto","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Anesthesiology Aichi Children's Health and Medical Center  Obu Aichi Japan"},{"name":"Department of Clinical Engineering Aichi Children's Health and Medical Center  Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroomi","family":"Murayama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Aichi Children's Health and Medical Center  Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Aoki","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Aichi Children's Health and Medical Center  Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Motomura","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine Aichi Children's Health and Medical Center  Obu Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7136-9815","authenticated-orcid":false,"given":"Taiki","family":"Kojima","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Aichi Children's Health and Medical Center  Obu Aichi Japan"},{"name":"Division of Comprehensive Pediatric Medicine Nagoya University Graduate School of Medicine  Nagoya Aichi Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000475"},{"issue":"3","key":"e_1_2_10_3_1","first-page":"380","article-title":"Extracorporeal membrane oxygenation in congenital heart disease","volume":"9","author":"Perry T","year":"2022","journal-title":"Children (Basel)"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000000150"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0112316"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1051\/ject\/201951061"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001332"},{"key":"e_1_2_10_8_1","volume-title":"ELSO Guidelines for Cardiopulmonary Extracorporeal Life Support Extracorporeal Life Support Organization, Version 1.4","year":"2017"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2013.12.008"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1177\/02676591231168642"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001121"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1080\/10543406.2019.1632876"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/rth2.12037"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0267659119899883"},{"key":"e_1_2_10_15_1","first-page":"87","volume-title":"Ecmo extracorporeal cardiopulmonary support in critical care, red book","author":"Annich Gail M","year":"2012"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14826","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T13:43:32Z","timestamp":1728913412000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.14826"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,15]]},"references-count":14,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1111\/aor.14826"],"URL":"https:\/\/doi.org\/10.1111\/aor.14826","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"value":"0160-564X","type":"print"},{"value":"1525-1594","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,15]]},"assertion":[{"value":"2024-03-20","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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