Surgery in Neonatal and Pediatric ECMO Patients Other Than Congenital Diaphragmatic Hernia Repair
| Autor: | Dick Tibboel, Casper M Kersten, Rene M. H. Wijnen, J. Marco Schnater, Sergei M. Hermelijn, Robert Jan Houmes |
|---|---|
| Přispěvatelé: | Pediatric Surgery |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
complications medicine.medical_treatment 030204 cardiovascular system & hematology Pediatrics RJ1-570 Fasciotomy surgery 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Laparotomy medicine Extracorporeal membrane oxygenation critical illness Thoracotomy Original Research business.industry Mortality rate post-surgical complications Congenital diaphragmatic hernia extracorporeal membrane oxygenation medicine.disease Surgery Cardiac surgery pediatric surgical procedures operative Pediatrics Perinatology and Child Health outcome neonate business Complication |
| Zdroj: | Frontiers in Pediatrics, 9:660647. Frontiers Media S.A. Frontiers in Pediatrics Frontiers in Pediatrics, Vol 9 (2021) |
| ISSN: | 2296-2360 |
| Popis: | Aim of Study: The use of extracorporeal membrane oxygenation (ECMO) has increased as a result of technological developments and the expansion of indications. Relatedly, the number of patients undergoing surgery during ECMO is also rising, at least in the adult population. Little is known on surgery in children during ECMO-therapy. We therefore aimed to assess the frequencies and types of surgical interventions in neonatal and pediatric patients on ECMO and to analyze surgery-related morbidity and mortality.Methods: We retrospectively collected information of all patients on ECMO over a 10-year period in a single tertiary and designated ECMO-center, excluding patients undergoing cardiac surgery, and correction of congenital diaphragmatic hernia. Chi-squared test and Mann-Whitney U test were used to analyze data.Main Results: Thirty-two of 221 patients (14%) required surgery when on ECMO. Common interventions were thoracotomy (32%), laparotomy (23%), fasciotomy (17%), and surgical revision of ECMO (15%). Complications occurred in 28 cases (88%), resulting in a 50% in-hospital mortality rate. Surgical patients had a longer ICU stay and longer total hospital stay compared to those not receiving surgery during ECMO. No significant difference in mortality was found when comparing surgical to non-surgical patients (50 vs. 41%).Conclusions: Approximately one in seven neonatal or pediatric patients required surgical intervention during ECMO, of whom almost 90% developed a complication, resulting in a 50% mortality rate. These results should be taken into account in counseling. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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