Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation (original) (raw)
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Extracorporeal membrane oxygenation for cardiac support in children
The Annals of Thoracic Surgery, 1996
Background. Extracorporeal membrane oxygenation (ECMO) support for cardiac failure has been used in children since 1981 at the Children's Hospital in Pittsburgh. Most children reqaired support after cardiac operations. Recently, however, a larger number of patients with decompensated cardiomyopathy or myocarditis have been supported with ECMO, which was used as a bridge to transplantatiem in most. Methods. From 1981 to 1994, 68 children were placed on ECMO for cardiac supporL Results. The overall survival for the entire time period was 38%, with the more recent experience survival increased to 47%. In 14 children, ECMO was used as a bridge to transplantation, with 9 children receiving a heart transplant and 7 long-term survivors. Extracorporeal membrane oxygenation has also been used to resuscitate 11 children after sudden cardiac arrest, with a long-term survival of 53%. Conclusions. We conclude that ECMO support for
Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience
Journal of Cardiothoracic Surgery
Background Extracorporeal membrane oxygenation (ECMO) has become an integral part of paediatric cardiac surgery. We report the experience of a well-established ECMO service over 5 years. Methods This retrospective study analysed all paediatric patients who required ECMO support following cardiac surgery from April 2015 to March 2020. Inclusion criteria were age less than 18 years and post-operative ECMO support. Patients were analysed dividing into groups according to the urgency for ECMO support (extracorporeal cardiopulmonary resuscitation (ECPR) and cardiac ECMO) and according to age (neonatal and paediatric ECMO groups). They were followed for 30-day, 6-month mortality, long-term survival, postoperative morbidity and the need for reintervention. Results Forty-six patients were included who had a total of venoarterial (VA) 8 ECMO runs. The 5-year incidence of the need for VA ECMO after cardiac surgery was 3.3% (48 of the overall 1441 cases recorded). The median follow-up period w...
The Journal of Heart and Lung Transplantation, 2019
Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is established therapy for shortterm circulatory support for children with life-treating cardiorespiratory dysfunction. In children with congenital heart disease (CHD), ECMO is commonly used to support patients with post-cardiotomy shock or complications including intractable arrhythmias, cardiac arrest, and acute respiratory failure. Cannulation configurations include central, when the right atrium and aorta are utilized in patients with recent sternotomy, or peripheral, when cannulation of the neck or femoral vessels are used in nonoperative patients. ECMO can be used to support any form of cardiac disease including univentricular palliated circulation. Although V-A ECMO is commonly used to support children with CHD, veno-venous ECMO (V-V ECMO) has been used in selected patients with hypoxemia or ventilatory failure in the presence of good cardiac function. ECMO use and outcomes in the CHD population are mainly informed by single-center studies and reports from collated registry data. Significant knowledge gaps remain, including optimal patient selection, timing of ECMO deployment, duration of support, anticoagulation, complications, and the impact of these factors on short-and long-term outcomes. This report, therefore, aims to present a comprehensive overview of the available literature informing patient selection, ECMO management, and in-hospital and early post-discharge outcomes in pediatric patients treated with ECMO for post-cardiotomy cardiorespiratory failure.
Nepalese Heart Journal, 2014
Background and Aim: Cardiac extra-corporeal membrane oxygenation is a mechanical life support system initiated in patients with extreme cardiopulmonary failure. Extracorporeal circulation after cardiac surgery supports the heart and lungs recover from the acute injuries of the surgery. Aims of this study were to present our initial experience about complications and outcome with the use of extracorporeal membrane oxygenation following open-heart surgery for congenital cardiac anomalies. Methods: Medical records of all pediatric and neonatal patients requiring extracorporeal life support following cardiac surgery for congenital cardiac anomalies were retrospectively reviewed. Patient and extracorporeal system characteristics were evaluated. Results: Between 2009 and 2012, eight children were treated at our institution with mechanical extracorporeal life support system following open heart surgery. Median age was four months and mean weight was 7.24 kilograms. The indications for init...
Pediatric surgical extracorporeal membrane oxygenation – a case series
Signa Vitae - A Journal In Intensive Care And Emergency Medicine, 2008
Objective. To review demographic and procedural factors and their association with weaning rate and survival from extracorporeal membrane oxygenation (ECMO) in pediatric patients undergoing repair of cardiac malformations. Methods. The hospital records of children requiring ECMO during cardiac operation due to failure to wean from cardiopulmonary by pass (CPB) were retrospectively reviewed, and an analysis of variables affecting survival was performed. Results. Thirty-five pediatric patients between January 1, 2000 and December 31, 2006 required ECMO for cardiopulmonary support during cardiac operations. ECMO survival was 54.3% and was comparable across all age groups. The lowest pH during ECMO treatment was the only predictor of mortality (P = 0.006). No other patient, surgical or anesthetic, factor was associated with either weaning from ECMO or hospital survival. Conclusions. No clear risk factor could be identified for survival from ECMO in our pediatric patients who underwent cardiac surgery and failed weaning from cardiopulmonary bypass.
Nederlandsch tijdschrift voor geneeskunde, 2006
Description of the results with extracorporeal membrane oxygenation (ECMO) in infants with cardiorespiratory failure after open-heart surgery. Prospective observational study. Data on the indications, survival, and complications were collected from all infants treated with ECMO for cardiorespiratory failure after open-heart surgery in the period 1996-2004 in the St Radboud University Medical Centre in Nijmegen, the Netherlands. 17 ECMO treatments were carried out in 16 paediatric patients: 7 girls and 9 boys. All patients had severe circulatory failure, sometimes combined with respiratory insufficiency. The patients' average age was 8 months (range: 1 day-3 years and 10 months). The average duration of treatment was 137 hours (range: 8-433). In 12 of the 17 ECMO treatments, the patient was successfully weaned from ECMO and 7 patients were discharged home. 5 patients died in hospital after successful ECMO treatment. 10 of the 16 patients died. A functional univentricular heart wa...