Pediatric extracorporeal cardiopulmonary resuscitation: single-center study
| Autor: | Zeynep Eyileten, Merve Havan, Özlem Selvi Can, Ahmet Rüçhan Akar, Tanıl Kendirli, Ercan Tutar, Çağdaş Baran, Mehmet Cakici, Tayfun Uçar, Burcu Arıcı, Serhan Özcan |
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| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_treatment Population Return of spontaneous circulation Single Center Article children medicine Extracorporeal membrane oxygenation Humans Extracorporeal cardiopulmonary resuscitation Cardiopulmonary resuscitation education Retrospective Studies Body surface area education.field_of_study business.industry Septic shock Infant General Medicine extracorporeal membrane oxygenation medicine.disease Cardiopulmonary Resuscitation Heart Arrest Survival Rate Treatment Outcome Child Preschool Anesthesia Female business |
| Zdroj: | Turkish Journal of Medical Sciences |
| ISSN: | 1303-6165 |
| Popis: | Background/aim Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to evaluate the clinical outcomes of our ECPR experience in a pediatric patient population. Materials and methods Between September 2014 and November 2017, fifteen children were supported with ECPR following in-hospital cardiac arrest (IHCA) in our hospitals. VA-ECMO setting was established for all patients. Pediatric cerebral performance category (PCPC) scales and long-term neurological prognosis of the survivors were assessed. Results The median age of the study population was 60 (4-156) months. The median weight was 18 (4.8-145) kg, height was 115 (63-172) cm, and body surface area was 0.73 (0.27-2.49) m2. The cause of cardiac arrest was a cardiac and circulatory failure in 12 patients (80%) and non-cardiac in 20%. Dysrhythmia was present in 46%, septic shock in 13%, bleeding in 6%, low cardiac output syndrome in 13%, and airway disease in 6% of the study population. Median low-flow time was 95 (range 20-320) minutes. Central VA-ECMO cannulation was placed in only 2 (13.3%) cases. However, the return of spontaneous circulation (ROSC) was obtained in 10 (66.6%) patients, and 5 (50%) of them survived. Overall, five patients discharged from the hospital. Finally, survival following ECPR was 33.3%, and all survivors were neurologically intact at hospital-discharge. Conclusion ECPR can be a life-saving therapeutic strategy using a promising technology in the pediatric IHCA population. For better survival rates, early initiation, well-coordinated, skilled, and dedicated ECMO team is the mainstay. |
| Databáze: | OpenAIRE |
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