Extracorporeal membrane oxygenation for cardiac failure after congenital heart operation
| Autor: | Michele Moss, Elizabeth A. Frazier, James E. Harrell, Stephen H. Van Devanter, Carl W. Chipman, Sherry C. Faulkner, James W. Fasules, Stanley Ziomek |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Heart Defects
Congenital Male Pulmonary and Respiratory Medicine Cardiac function curve medicine.medical_specialty Hypertension Pulmonary medicine.medical_treatment Cardiac Output Low law.invention Extracorporeal Membrane Oxygenation Postoperative Complications Refractory law Cardiopulmonary bypass Extracorporeal membrane oxygenation medicine Humans Child Postoperative Care business.industry Infant Newborn Infant Intensive care unit Surgery Ventricular failure surgical procedures operative Child Preschool Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The Annals of Thoracic Surgery. 54:861-868 |
| ISSN: | 0003-4975 |
| Popis: | Despite continuing improvement in myocardial protection and surgical technique, the repair of complex congenital heart lesions can result in cardiopulmonary compromise refractory to conventional therapy. In a 29-month period, 24 patients (aged 14 hours to 6 years) were treated with extracorporeal membrane oxygenation (ECMO) 28 times for profound cardiopulmonary failure. Four patients required ECMO after each of two cardiopulmonary bypass procedures. Seventeen patients required ECMO to be initiated in the operating room: 12 (71%) were weaned successfully from ECMO, and 8 (47%) survived. Seven patients had ECMO initiated in the intensive care unit: 6 (86%) were weaned, and 5 (71%) survived. Serial echocardiograms demonstrated substantial recovery of cardiac function in 18 of 21 instances (86%) of ventricular failure from myocardial dysfunction. Overall, 18 of 24 patients (75%) were successfully weaned from ECMO including all 4 who underwent 2 ECMO treatments. We conclude that ECMO can successfully salvage children who have serious cardiopulmonary failure immediately after a congenital heart operation and that long-term survival is possible after two ECMO treatments. |
| Databáze: | OpenAIRE |
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