Histopathological features of open lung biopsies in children treated with extracorporeal membrane oxygenation (ECMO)

Background: Extracorporeal membrane oxygenation (ECMO) has become an established treatment for severe respiratory distress in a range of pediatric conditions. This study describes the histopathotogical features in a series of 22 children receiving ECMO therapy in whom open lung biopsy was carried out. Aims: To describe the histopathological features of open lung biopsies in children receiving ECMO therapy. Study design: Retrospective review of clinical material. Subjects: Children receiving ECMO therapy in whom open lung biopsy was carried out. Results: In those investigated in infancy, open lung biopsy allowed a definite diagnosis to be made of the underlying condition in more than 90% of cases. In older children, the histopathological changes were more non-specific and, although providing useful clinical information, a definitive diagnosis could often not be made. In about a quarter of cases, there are additional pathological features, which may be related to ECMO treatment, such as significant intra-alveolar haemorrhage, but ECMO does not in itself impair the diagnostic usefulness of open lung biopsy in these selected patients. Conclusion: Open lung biopsy provides clinically useful information in infants receiving ECMO therapy. The histopathological changes may be complex and represent both the effects of ECMO and progression of the underlying disease. (c) 2004 Elsevier Ireland Ltd. AR rights reserved.