Drowning and ECMO: using the CARE guidelines for case reports

There are many reporting guidelines for writing up your research and the EQUATOR website, houses them all (https://www.equator-network.org/reporting-guidelines/). In there is the CARE guideline for case reports (https://www.care-statement.org/). Lucina was impressed by the way a set of researchers used this statement, to address the issue of re-cooling and extracorporeal membrane oxygenation (ECMO) after drowning, hypothermia and out of hospital cardiac arrest (OHCA). MC Andre et al (Pediatric Critical Care Medicine 2023;24(9):e417-e424. DOI: 10.1097/PCC.0000000000003254) reported a 2-year-old girl who drowned and presented with an OHCA and hypothermia (23°C). They highlighted that ECMO is used in drowning-associated hypothermia and OHCA in adults but current paediatric guidelines do not recommend ECMO in children in this clinical situation. Using the CARE approach to the literature, they identified 24 reports (57 patients including their case) in the “PubMed database” focusing on children younger than 6 years old with a temperature less than to 28°C who had been rewarmed using conventional intensive care some with and some without ECMO. Despite recommendations, 44 children (all pulseless on arrival) had ECMO, and 13 children (eight children pulseless) did not. 12 of 13 children (92%) undergoing conventional rewarming survived compared with 18 of 44 children (41%) undergoing …