{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T05:06:43Z","timestamp":1790053603083,"version":"4.0.1"},"reference-count":16,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Refractory septic shock (RSS) in children carries high mortality despite advances in critical care. Extracorporeal membrane oxygenation (ECMO) is a rescue therapy when conventional management fails. Evidence from Latin America remains limited, with no detailed reports from Chile.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a retrospective single-center study (2009\u20132024) in a Chilean Pediatric ICU. Patients aged 1\u2009month to 17\u2009years with septic shock unresponsive to maximal conventional therapy were included. We analyzed demographics, illness severity, ECMO modality, complications, and outcomes. Primary endpoint was survival to hospital discharge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Nine patients received ECMO (median age\u2009=\u20096.3\u2009years). All had RSS, frequently associated with severe ARDS. Configurations included venoarterial (VA;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094), venovenous (VV;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20094), and venoarteriovenous (VAV;\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091), all via peripheral cannulation. Pre-ECMO median vasoactive-inotropic score was 117, and 78% required renal replacement therapy during ECMO. Overall survival was 55% (5\/9). Survivors had longer ECMO runs (median 11\u2009days vs 3\u2009days) and ICU stays (median 63\u2009days vs 5\u2009days). Hemorrhage was the most frequent complication (intracranial\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20093; gastrointestinal\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u20091). One survivor developed hemiparesis; no cognitive impairment was observed at 1-year follow-up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>ECMO can be an effective rescue therapy for pediatric RSS, even without central cannulation capability. Distinguishing cardiogenic from vasoplegic phenotypes and identifying severe ARDS guided configuration selection (VA vs VV). These findings highlight the feasibility of peripheral ECMO in carefully selected patients within resource-limited settings, achieving survival comparable to international reports.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03913988251409039","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T12:04:46Z","timestamp":1768565086000},"page":"17-22","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracorporeal membrane oxygenation in pediatric septic shock: A single-center experience in Chile"],"prefix":"10.1177","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3800-2348","authenticated-orcid":false,"given":"Loreto","family":"Godoy","sequence":"first","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0767-7160","authenticated-orcid":false,"given":"Mauricio","family":"Yunge","sequence":"additional","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge","family":"Rufs","sequence":"additional","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandra","family":"Gatica","sequence":"additional","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Mu\u00f1oz","sequence":"additional","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5602-4505","authenticated-orcid":false,"given":"Cristian","family":"Valverde","sequence":"additional","affiliation":[{"name":"Clinica Las Condes and Universidad Finis Terrae, Santiago, Regi\u00f3n Metropolitana, Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2024.0179"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PCC.0000149131.72248.E6"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2021.791781"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000003692"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001464"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-019-05720-z"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001660"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001147"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-002-1601-2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00079"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-020-03418-z"},{"key":"e_1_3_2_13_2","first-page":"1","article-title":"Extracorporeal membrane oxygenation for refractory septic shock in children","volume":"20","author":"Yang Y","year":"2024","unstructured":"Yang Y, Wang X, Huang J, et al. Extracorporeal membrane oxygenation for refractory septic shock in children. Signa Vitae 2024; 20: 1\u20137.","journal-title":"Signa Vitae"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpedsurg.2011.10.018"},{"key":"e_1_3_2_15_2","article-title":"Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children","volume":"46","author":"Weiss SL","year":"2020","unstructured":"Weiss SL, Peters MJ, Alhazzani W, et al. Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children. Intensive Care Med 2020; 46(Suppl 1): S10\u2013S67.","journal-title":"Intensive Care Med"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2022.12.014"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/02676591211056562"}],"container-title":["The International Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988251409039","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03913988251409039","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988251409039","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T04:48:29Z","timestamp":1790052509000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03913988251409039"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1177\/03913988251409039"],"URL":"https:\/\/doi.org\/10.1177\/03913988251409039","relation":{},"ISSN":["0391-3988","1724-6040"],"issn-type":[{"value":"0391-3988","type":"print"},{"value":"1724-6040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}