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Objective To investigate the application and safety of mobile extracorporeal membrane oxygenation (ECMO) in inter-hospital transport of pediatric patients with acute respiratory distress syndrome (pARDS). Methods Data were retrospectively collected of children with pARDS transported by mobile ECMO from Jan. 1, 2019 to Nov. 25, 2019. All children suffered from severe ARDS, and the curative effect in their local hospital was not good, the disease was still progressing after traditional conservative treatments such as mechanical ventilation (MV), small tidal volume protective ventilation, prone position ventilation, and fluid restriction, and the severity of the disease reached the applicable ECMO indications. The age, sex, clinical manifestations, ECMO transfer time, ECMO transfer distance, ECMO duration, MV duration, length of hospital stay, prognosis and complications were collected and analyzed. Results Seven pediatric patients were included in present study including 6 males and 1 female, aged (43.3±42.9) months, body weight (18.4±17.7) kg, ECMO travel distance (9.4±8.9) km, and ECMO travel time (5.7±17.2) min. After arriving in the Guangdong Provincial People's Hospital, 6 pediatric patients (4 were cured and 2 died) were discharged and 1 pediatric patient was still being treated. The MV duration was (17±11) d, ECMO duration was (307.4±233.6) h, and the length of hospital stay was (23±15) d. Of the 7 pediatric patients, 4 were caused by adenovirus infection, and the other 3 cases were infected by unclear pathogenic bacteria. The cause for death was severe sepsis shock combined with severe heart dysfunction and severe pulmonary hemorrhage. Conclusions With a skilled ECMO teams, mobile ECMO may provide a safe and effective inter-hospital transport of pARDS patients. Mobile ECMO provides a good way to treat children patients with respiratory critical condition. DOI: 10.11855/j.issn.0577-7402.2020.04.15

Background Capillary leak syndrome (CLS) is a rare disease characterized by profound vascular leakage and presents as a classic triad of hypotension, hypoalbuminemia and hemoconcentration. Severe CLS is mostly induced by sepsis and generally life-threatening in newborns, especially in premature infants. Continuous renal replacement therapy (CRRT) plays an important role of supportive treatment for severe CLS. Unfortunately, CRRT in preterm infants has rarely been well defined. Case presentation We report the case of a 11-day-old girl with CLS caused by sepsis, who was delivered by spontaneous vaginal delivery (SVD) at gestational age of 25 weeks and 4 days, and a birth weight of 0.89 Kilograms(kg). The infant received powerful management consisting of united antibiotics, mechanical ventilation, intravenous albumin and hydroxyethyl starch infusion, vasoactive agents, small doses of glucocorticoids and other supportive treatments. However, the condition rapidly worsened with systemic edema, hypotension, pulmonary exudation, hypoxemia and anuria in about 40 h. Finally, we made great efforts to perform CRRT for her. Fortunately, the condition improved after 82 h’ CRRT, and the newborn was rescued and gradually recovered. Conclusion CRRT is an effective rescue therapeutic option for severe CLS and can be successfully applied even in extremely-low-birth-weight premature.