Comparative Review of Outcomes in Patients With Congenital Heart Disease Requiring Cardiopulmonary Support for Failure to Wean From Cardiopulmonary Bypass or for Refractory Sudden Cardiac Arrest
| Autor: | Monica C. Olsen, William M. DeCampli, Kamal K. Pourmoghadam, Michael C. O’Brien, Moui Nguyen |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
Heart Defects
Congenital Male medicine.medical_specialty Heart disease medicine.medical_treatment Heart Ventricles law.invention Extracorporeal Membrane Oxygenation Refractory law Internal medicine medicine Extracorporeal membrane oxygenation Cardiopulmonary bypass Humans In patient Cardiopulmonary resuscitation Cardiopulmonary Bypass business.industry Infant Sudden cardiac arrest General Medicine medicine.disease Cardiopulmonary Resuscitation Death Sudden Cardiac Treatment Outcome Heart failure Pediatrics Perinatology and Child Health Cardiology Surgery Female medicine.symptom Cardiology and Cardiovascular Medicine business Epidemiologic Methods |
| Zdroj: | World journal for pediatriccongenital heart surgery. 6(3) |
| ISSN: | 2150-136X |
| Popis: | Background: We reviewed the outcomes of patients who underwent cardiopulmonary support (CPS) for either refractory sudden cardiac arrest or failure to wean from cardiopulmonary bypass (CPB). Methods: Between January 2005 and July 2013, 37 patients with congenital heart disease (CHD) underwent 39 instances of CPS for sudden cardiac arrest as extracorporeal cardiopulmonary resuscitation (E-CPR; group I, n = 19) or for failure to wean from CPB (group II, n = 20). Univariate analyses determined which variables differed among the groups and which had significant association with hospital survival. Binary logistic regression determined the significant associations in a multivariable model. Results: Overall 30-day and hospital survival were 76.9% (30) and 69.2% (27), respectively. For groups I and II, hospital survival was 68.4% (13) and 70.0% (14), respectively. Variables associated with mortality in the univariate analysis included hours on CPS ( P = .045), initial aspartate aminotransferase (AST) level on CPS ( P = .007), and bicarbonate 24 hours on CPS ( P = .004). Logistic regression showed single-ventricle physiology ( P = .05), initial AST level on CPS ( P = .03), and lower bicarbonate 24 hours on CPS ( P = .026) to be significantly associated with mortality. Conclusions: Comparable rates of survival to discharge can be obtained when CPS is initiated for E-CPR or for failure to wean from CPB in resuscitating patients with CHD. Hepatic and renal factors indicative of inadequate early tissue perfusion, single-ventricle physiology, and lower bicarbonate level are factors associated with poor outcome. |
| Databáze: | OpenAIRE |
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