Favorable outcome of pediatric fulminant myocarditis supported by extracorporeal membranous oxygenation
| Autor: | Berant Michel, Elhanan Nahum, Einat Birk, Jacob Katz, George Frenkel, Gabriel Amir, Ovdi Dagan, Amiram Lev, Golan Shukrun |
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| Rok vydání: | 2010 |
| Předmět: |
Male
medicine.medical_specialty Circulatory collapse Myocarditis medicine.medical_treatment Fulminant Severity of Illness Index Extracorporeal Extracorporeal Membrane Oxygenation Internal medicine medicine Extracorporeal membrane oxygenation Humans Child Ultrasonography Heart transplantation business.industry Infant Newborn Infant medicine.disease Cardiac surgery Transplantation Treatment Outcome Child Preschool Pediatrics Perinatology and Child Health Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pediatric cardiology. 31(7) |
| ISSN: | 1432-1971 |
| Popis: | Myocarditis among pediatric patients varies in severity from mild disease to a fulminant course with overwhelming refractory shock and a high risk of death. Because the disease is potentially reversible, it is reasonable to deploy extracorporeal membranous oxygenation (ECMO) to bridge patients until recovery or transplantation. This study aimed to review the course and outcome of children with acute fulminant myocarditis diagnosed by clinical and echocardiographic data only who were managed by ECMO because of refractory circulatory collapse. A chart review of a single center identified 12 children hospitalized over an 8-year period who met the study criteria. Data were collected on demographics, diagnosis, disease course, and outcome. The patients ranged in age from 20 days to 8 years (25.5 ± 29.6 months). Echocardiography showed a severe global biventricular decrease in myocardial function, with a shortening fraction of 12% or less. Ten children (83.3%) were weaned off extracorporeal support after 100-408 h (mean, 209.9 ± 82.4 h) and discharged home. Two patients died: one due to multiorgan failure and one due to sustained refractory heart failure. During a long-term follow-up period, all survivors showed normal function in daily activities and normal myocardial function. The study showed that ECMO can be safely and successfully used for children with acute fulminant myocarditis diagnosed solely on clinical and radiographic grounds who need mechanical support. These patients usually have a favorable outcome, regaining normal or near normal heart function without a need for heart transplantation. |
| Databáze: | OpenAIRE |
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