Extracorporeal membrane oxygenation for cardiac failure after congenital heart operation

Ziomek, Stanley; Harrell, James E.; Fasules, James W.; Faulkner, Sherry C.; Chipman, Carl W.; Moss, Michele; Frazier, Elizabeth A.; Devanter, Stephen H. Van

doi:10.1016/0003-4975(92)90638-k

Cited by 72 publications

(36 citation statements)

References 20 publications

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“…Over the past decade, the number of children successfully treated by ECMO has increased gradually[3,5-9]. Since the practice and outcome of ECMO varies widely among the different centers around the world, we studied the long-term outcome of children who had circulatory support with VA-ECMO following repair of congenital heart defects in our institution, with a view to identify the possible risk factors associated with hospital mortality.…”

Section: Introductionmentioning

confidence: 99%

Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

Balasubramanian

Tiruvoipati

Amin

et al. 2007

J Cardiothorac Surg

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Section: Introductionmentioning

confidence: 99%

Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support

Balasubramanian

Tiruvoipati

Amin

et al. 2007

J Cardiothorac Surg

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“…Hence, it has been widely used for circulatory support after cardiac surgery with survival to hospital discharge being reported at 40-50%. [1][2][3][4][5][6][7][8][9][10][11][12] It has also been used for a variety of cardiac medical conditions such as cardiomyopathy and myocarditis. [13][14][15] However, there is only limited information on predictors of outcome and long term survival after hospital discharge in this ECMO population.…”

mentioning

confidence: 99%

Cardiac ECMO for biventricular hearts after paediatric open heart surgery

Chaturvedi

2004

Heart

119

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Objective: To delineate predictors of hospital survival in a large series of children with biventricular physiology supported with extracorporeal membrane oxygenation (ECMO) after open heart surgery. Results: 81 children were placed on ECMO after open heart surgery. 58% (47 of 81) were transferred directly from cardiopulmonary bypass to ECMO. Hospital survival was 49% (40 of 81) but there were seven late deaths among these survivors (18%). Factors that improved the odds of survival were initiation of ECMO in theatre (64% survival (30 of 47)) rather than the cardiac intensive care unit (29% survival (10 of 34)) and initiation of ECMO for reactive pulmonary hypertension. Important adverse factors for hospital survival were serious mechanical ECMO circuit problems, renal support, residual lesions, and duration of ECMO. Conclusions: Hospital survival of children with biventricular physiology who require cardiac ECMO is similar to that found in series that include univentricular hearts, suggesting that successful cardiac ECMO is critically dependent on the identification of hearts with reversible ventricular dysfunction. In our experience of postoperative cardiac ECMO, the higher survival of patients cannulated in the operating room than in the cardiac intensive care unit is due to early effective support preventing prolonged hypoperfusion and the avoidance of a catastrophic cardiac arrest.

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“…The weaning rate from ECMO was 68.7%, and the hospital survival was 54.3% which is the range reported by others. (5,9,10) The small number of children in present study does not allow for comprehensive analysis of risk factors. Therefore, we conducted only an exploratory analysis which did not identify any demographic or procedural characteristics associated with outcome including age, gender, ASA PS, primary cardiac physiology (univentricular vs. biventricular), type of repair (complete vs. incomplete), use of circulatory arrest, intraoperative use of ultrafiltration or need for preoperative ventricular assist (left ventricular assist device or intra-aortic balloon pump), and shorter anesthetic course before initiation of ECMO.…”

Section: Discussionmentioning

confidence: 90%

“…(1) Occasionally this complication may be refractory even to the most intensive pharmacologic therapy and the use of extracorporeal membrane oxygenator (ECMO) may be the only alternative. A significant body of literature exists regarding the use of ECMO in postoperative course after cardiac surgery in children, (2)(3)(4)(5) and more limited information exists regarding the use of intraoperative ECMO. In present study we report outcome in 35 pediatric patients who received ECMO intraoperatively after failing weaning from CPB following repair of complex heart malformations.…”

Section: Introductionmentioning

confidence: 99%