Elective Extracorporeal Membrane Oxygenation Support for High-Risk Pediatric Cardiac Catheterization

Zaleski, Katherine L.; Scholl, Rebecca; Thiagarajan, Ravi R.; Porras, Diego; Mah, Douglas Y.; DiNardo, James A.; Nasr, Viviane G.

doi:10.1053/j.jvca.2019.01.008

Cited by 7 publications

(7 citation statements)

References 11 publications

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“…Similar to our results, Moscatelli also did not find any cannulation‐related differences between groups, whereas Zaleski et al depicted that central ECMO cannulation in high‐risk pediatric cardiac procedures increased survival rates of patients, but it should be noted as stated by Garcia et al that consensus on pediatric cannulation strategies and management does not currently exist …”

Section: Discussionsupporting

confidence: 90%

“…Survival rates and life expectancy after use of veno‐arterial extracorporeal membrane oxygenation (vaECMO) for severe cardiac failure increased in the last years. vaECMO became the most commonly used form of mechanical support in neonatal and pediatric cardiac disorders . The Extracorporeal Life Support Organization reports an increasing survival to discharge for all neonatal postcardiotomy ECMO patients .…”

Section: Introductionmentioning

confidence: 99%

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Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30‐day outcomes; mid‐ and long‐term survival. A single center experience

et al. 2019

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Nowadays, an increasing number of neonatal and pediatric patients with severe heart failure benefits from extracorporeal membrane oxygenation (ECMO) support. A total of 39 pediatric patients needed venoarterial ECMO (vaECMO) support in our department between January 2008 and December 2016. Patients were retrospectively divided in two groups: 30-day survivor group (17 patients) and 30-day nonsurvivor group (22 patients). Outcome and factors predictive for 30-day mortality and mid-as well as long-term survival up to 7-year follow-up were analyzed by univariate analysis and Kaplan-Meier survival estimation. Basic demographics andpreoperative characteristics did not differ between groups (P > 0.05). 67% of patients were successfully weaned off ECMO and 44% survived 30-day after ECMO application. After 7-year follow-up 28% of pediatric patients were alive. Thirtyday survivors were significantly more likely to undergo elective cardiac surgery (P = 0.001), whereas significantly more 30-day nonsurvivors underwent urgent surgery (P = 0.004). Odds of incidence of catecholamine refractory circulatory failure, failed myocardial recovery, and cerebral edema was significantly higher in 30-day nonsurvivor group (41.6-fold, 16-fold, and 2.5-fold, respectively). Kaplan-Meier survival estimation analysis revealed significant differences in terms of mid-and long-term survival among neonates, infants, toddlers, and preadolescents (Breslow P = 0.037 and Log-Rank P = 0.028, respectively). vaECMO provides an efficient therapy option for life-threatening heart disorders in neonates and pediatric patients being at high risk for myocardial failure leading to circulatory arrest. Urgency of surgery effected on higher mortality, but there was no difference in terms of mortality in 30-day survivor group in comparison to 30-day nonsurvivor group among neonates, infants, toddlers, and preadolescents. K E Y W O R D S30-day outcome, congenital cardiac surgery, extracorporeal membrane oxygenation, heart failure, pediatric and neonatal patients, resuscitation

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30‐day outcomes; mid‐ and long‐term survival. A single center experience

et al. 2019

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“…A small series depicted promising results of preemptive ECMO cannulation use, instead of emergent cannulation, in children with high-risk catheterization procedures. 12…”

Section: Discussionmentioning

confidence: 99%

The Use of Intraoperative Peripheral Extracorporeal Membrane Oxygenation in High-Risk Airways Tumor Removal Procedures in Neonates and Children

et al. 2021

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Airway surgery involving trachea or main stem bronchi in neonates and children is challenging. The use of extracorporeal support for such unusual indications is poorly described. Here, we report on three patients receiving peripheral extracorporeal membrane oxygenation (ECMO) to maintain adequate ventilation while improving surgical site exposure. Case 1 is a 9-year-old boy diagnosed with proximal left stem bronchus endoluminal tumor; cases 2 and 3 are a neonate and a young infant diagnosed with a subcarinal bronchogenic cyst. Planned ECMO use consisted in peripheral venoarterial cannulation through jugular and carotid access. There was no bleeding complication during and after surgical care. Hemodynamic and respiratory supports were optimized in all cases. Children were successfully weaned off ECMO immediately after surgery. Planned peripheral ECMO cannulation offers optimal conditions for high-risk airway surgery in neonates and children.

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“…59 High-risk coronary interventions are commonly performed in adults using some of these devices, including ECMO. 60 Due to their small size and complex anatomy of congenital cardiac defects, however, there are a limited number of suitable devices available for children. Venoarterial ECMO is usually the only option in small children (usually <15 Kg), but there is extensive experience with this modality.…”

Section: Cardiovascular Collapse and Mechanical Circulatory Support (...mentioning

confidence: 99%

“…In a separate group of ten patients who required ECMO emergently as part of ECPR due to sudden hemodynamic deterioration, the survival to discharge was 30%. 60 Clearly, ECMO is extremely invasive, but if the risk of ECMO is less than the risk of the procedure and the consequences of cardiovascular collapse, then it must be given serious consideration. In older children with isolated left or right ventricular dysfunction, there are more options for temporary percutaneous cardiac support.…”

Section: Cardiovascular Collapse and Mechanical Circulatory Support (...mentioning

confidence: 99%

Anesthetic Considerations in Pediatric Patients With Acute Decompensated Heart Failure

Sebastian

Ullah

Motta

et al. 2021

Semin Cardiothorac Vasc Anesth

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Acute decompensated heart failure (ADHF) in pediatrics is a significant cause for morbidity and mortality in children. Congenital heart disease and cardiomyopathy are the leading etiologies of ADHF. It is common for these children to undergo diagnostic, therapeutic, or surgical procedure under anesthesia, which may be associated with significant morbidity and mortality. The importance of preanesthetic multidisciplinary planning with all involved teams, including anesthesia, cardiology, intensive care, perfusion, and cardiac surgery, cannot be emphasized enough. In order to safely manage these patients, it is imperative for the anesthesiologist to understand the complex pathophysiological interactions between cardiopulmonary systems and anesthesia during these procedures. This review discusses the etiology, pathophysiology, clinical manifestations, and perioperative management of these patients.

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Elective Extracorporeal Membrane Oxygenation Support for High-Risk Pediatric Cardiac Catheterization

Cited by 7 publications

References 11 publications

Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30‐day outcomes; mid‐ and long‐term survival. A single center experience

Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30‐day outcomes; mid‐ and long‐term survival. A single center experience

The Use of Intraoperative Peripheral Extracorporeal Membrane Oxygenation in High-Risk Airways Tumor Removal Procedures in Neonates and Children

Anesthetic Considerations in Pediatric Patients With Acute Decompensated Heart Failure

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