Introduction: ECLS is used frequently as a rescue therapy for patients with respiratory failure unresponsive to conventional modes of therapy. Several agents are common pediatric viral pathogens which can cause severe respiratory distress including obliterative bronchiolitis and necrotizing pneumonia. We report our experience with pneumonitis secondary to confirmed viral agents.

Methods: We reviewed our cases from May 1985 through December 1995. A total of 332 patients (excluding cardiac patients) had undergone ECLS and ten patients were diagnosed with viral pneumonia. Method of diagnosis included nasopharyngeal (9) and rectal swabs (1) and monoclonal antibody testing. Data obtained included age, weight, sex, method of diagnosis, duration of ECLS, length of hospitalization, oxygenation index, outcome and neurological status.

Results: Diagnoses included: Parainfluenza type 2 (1); Adenovirus (2); Herpes simplex type 2 (2); Respiratory Syncytial Virus (RSV)(4); Enterovirus (1). Age ranged from 1 day to 120 days. Seven infants were male and three female.

Survival: Adenovirus (0); Parainfluenza (1); RSV (3); Herpes (1); Enterovirus (0). Table

Table 1
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Conclusion: Only 3 out of 4 infants with RSV pneumonia survived. Neither of our patients with adenovirus survived and both infants developed multiple organ failure. Apart from the type of viral agent and the development of multi-organ failure, we were unable to identify any predictors of survival. Overall survival data corroborates the ELSO registry data which indicates that only 102 out of 200 (51%) of infants with viral pneumonia survive.