Predictors of mortality and neurological morbidity in children undergoing extracorporeal life support for cardiac disease
| Autor: | Gabrielle de Veber, John G. Coles, Brian W. McCrindle, David Edgell, Gabriel Chow, Bhagawan Koirala, Derek Armstrong, Desmond Bohn |
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| Rok vydání: | 2004 |
| Předmět: |
Heart Defects
Congenital Male Pulmonary and Respiratory Medicine Extracorporeal Circulation Pediatrics medicine.medical_specialty Adolescent medicine.medical_treatment Risk Factors Epidemiology medicine Extracorporeal membrane oxygenation Humans Outpatient clinic Hospital Mortality Cardiopulmonary resuscitation Child Retrospective Studies business.industry Incidence (epidemiology) Infant Newborn Infant General Medicine Survival Analysis Surgery Treatment Outcome El Niño Child Preschool Life support Female Nervous System Diseases Cardiology and Cardiovascular Medicine business Cohort study |
| Zdroj: | European Journal of Cardio-Thoracic Surgery. 26:38-43 |
| ISSN: | 1010-7940 |
| DOI: | 10.1016/j.ejcts.2004.04.010 |
| Popis: | Objectives: The objective of this study was to determine the incidence and risk factors for death and adverse neurological outcomes in children receiving extracorporeal life support (ECLS) for cardiac indications. Methods: A retrospective single centre consecutive cohort study was conducted in children who received ECLS for cardiac indications between January 1990 and June 2000. Health records and neuroimaging films were assessed, and long-term outcomes were obtained by standardized telephone follow-up or by assessments performed in outpatient clinic. Clinical, neuroimaging and surgical predictors of outcome were tested. Results: Of 90 children studied, short-term clinical neurological events (during hospitalization) occurred in 20 children (22%) during or following ECLS. Long-term neurological sequelae were present in 11 of 31 children discharged alive, after a mean follow-up interval of 4.5 years (range 4 months to 9 years). Death occurred in 59 children (66%) during hospitalisation, and in 3 following discharge. Of the 28 long-term survivors, only 15 children (17%) survived without neurological sequelae. Abnormal neuroimaging was associated with short-term neurological events (P ¼ 0:03; OR 10.5), and the use of CPR prior to ECLS (P ¼ 0:02; OR 2.9) was the only significant predictor of death. There were no significant predictors of long-term neurological sequelae. Conclusions: More than two-thirds of the children receiving ECLS died, and 39% (11/28) of long-term survivors had neurological deficits. Although mortality is close to 100% without this type of support, there is still a significantly high morbidity and mortality with this type of support. q 2004 Elsevier B.V. All rights reserved. |
| Databáze: | OpenAIRE |
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