Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure
| Autor: | Gerardus Bennink, Kaveh Eghbalzadeh, Ilija Djordjevic, Thorsten Wahlers, Axel Kroener, Sergey Saenko, Javid Fatullayev, Anton Sabashnikov, Mohamed Zeriouh, Carolyn Weber, Farid Azizov, Julia Merkle |
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| Rok vydání: | 2019 |
| Předmět: |
Pulmonary and Respiratory Medicine
Resuscitation medicine.medical_specialty Heart disease business.industry medicine.medical_treatment 030208 emergency & critical care medicine 030204 cardiovascular system & hematology medicine.disease Cardiac surgery 03 medical and health sciences surgical procedures operative 0302 clinical medicine Respiratory failure Anesthesia Extracorporeal membrane oxygenation Clinical endpoint Medicine Original Article Extracorporeal cardiopulmonary resuscitation business Survival analysis |
| Zdroj: | Journal of Thoracic Disease. 11:S871-S888 |
| ISSN: | 2077-6624 2072-1439 |
| DOI: | 10.21037/jtd.2018.11.107 |
| Popis: | BACKGROUND: Mortality and morbidity after surgical repair for complex congenital heart defects and severe cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO) support remain high despite significant advances in medical management and technological improvements. We report on outcomes and factors after using ECMO in our surgical pediatric population including short- and long-term survival. METHODS: A total of 45 neonatal and pediatric patients were identified who needed ECMO in our department between January 2008 and December 2016. In 41 cases (91%) a vaECMO (ECLS) was implemented, whereas 4 patients (9%) received vvECMO treatment for respiratory failure. In 33 cases vaECMO was implanted following cardiac surgery for congenital heart disease (CHD), whereas in 8 patients ECMO was utilized by means of extracorporeal cardiopulmonary resuscitation (eCPR) following refractory cardiac arrest. The primary endpoint of the present study was survival to discharge and long-term survival free from neurological impairments. Univariate and bivariate analysis was performed to address predictors for outcome. Kaplan-Meier survival analysis was used to address mid- and long-term survival. RESULTS: Median [IQR] duration of ECMO support was 3 [2, 5] days (range, 1–17 days). Median age at ECMO implantation was 128 [14, 1,813] days, median weight of patients was 5.4 [3.3, 12] kg. Totally 10 patients included in this study were diagnosed with concomitant genetic conditions. A total of 20 (44%) patients were successfully weaned off ECMO (survived >24 h after ECMO explantation), whereas 15 (33%) of them survived to discharge. Single ventricle (SV) repair was performed in 14, biventricular repair in 19 patients. Neonates ( |
| Databáze: | OpenAIRE |
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