Extracorporeal membrane oxygenation for neonatal collapse caused by enterovirus myocarditis

Cortina, Gérard; Best, Derek; Deisenberg, Markus; Chiletti, Roberto; Butt, Warwick

doi:10.1136/archdischild-2016-312429

Cited by 19 publications

(20 citation statements)

References 26 publications

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“…In this article, Cortina et al also included 35 cases of Enterovirus Myocarditis supported with ECMO from literature review in their data analysis. The survival rate of all those cases together was 36% (15/42), which is lower than survival (to discharge or transfer) reported in the ELSO registry with 52% for this population (12).…”

Section: Indicationscontrasting

confidence: 61%

“…Looking at the ELSO data registry, out of 2,252 neonatal cardiac runs (2014–2018), myocarditis was listed in only 25 cases as the reason for ECMO initiation (1). A recently published article from Melbourne described a series of seven neonatal myocarditis cases requiring ECMO due to Enterovirus infection (12). In this article, Cortina et al also included 35 cases of Enterovirus Myocarditis supported with ECMO from literature review in their data analysis.…”

Section: Indicationsmentioning

confidence: 99%

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Neonatal Cardiac ECMO in 2019 and Beyond

Roeleveld

Mendonca

2019

Front. Pediatr.

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Worldwide, the use of Extracorporeal Membrane Oxygenation (ECMO) for cardiac failure has been steadily increasing in the neonatal population and has become a widely accepted modality. Especially in centers caring for children with (congenital) heart disease, ECMO is now an essential part of care available for those with severe heart failure as a bridge to recovery, long term mechanical support, or transplantation. Short-term outcomes depend very much on indication. Hospital survival is ~40% for all neonatal cardiac ECMO patients combined. ECMO is being used for pre- and/or post-operative stabilization in neonates with congenital heart disease and in neonates with medical heart disease such as myocarditis, cardiomyopathy or refractory arrhythmias. ECMO use during resuscitation (ECPR) or for sepsis is summarized elsewhere in this special edition of Frontiers in Pediatrics. In this review article, we will discuss the indications for neonatal cardiac ECMO, the difficult process of patients' selection and identifying the right timing to initiate ECMO, as well as outline pros and cons for peripheral vs. central cannulation. We will present predictors of mortality and, very importantly, predictors of survival: what can be done to improve the outcomes for your patients. Furthermore, an overview of current insights regarding supportive care in neonatal cardiac ECMO is given. Additionally, we will address issues specific to neonates with single ventricle physiology on ECMO, for example cannulation strategies and the influence of shunt type (Blalock-Taussig shunt vs. “right ventricle to pulmonary artery” shunt). We will not only focus on short term outcomes, such as hospital survival, but also on the importance of long-term neuro-developmental outcomes, and we will end this review with suggestions for future research.

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Section: Indicationscontrasting

confidence: 61%

Section: Indicationsmentioning

confidence: 99%

Neonatal Cardiac ECMO in 2019 and Beyond

Roeleveld

Mendonca

2019

Front. Pediatr.

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“…In these cases, ECMO may be used as a bridge to recovery (e.g., viral myocarditis), bridge to heart transplantation or ventricular assist device, or bridge to decision-making. Survival is poor for cardiomyopathies, often fatal, while it is relatively good for viral myocarditis [77,78].…”

Section: Ecmo For Neonatal Cardiac Failurementioning

confidence: 99%

Neonatal respiratory and cardiac ECMO in Europe

et al. 2021

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Neonatal extracorporeal membrane oxygenation (ECMO) is a life-saving procedure for critically ill neonates suffering from a potentially reversible disease, causing severe cardiac and/or respiratory failure and refractory to maximal conventional management. Since the 1970s, technology, management, and clinical applications of neonatal ECMO have changed. Pulmonary diseases still represent the principal neonatal diagnosis, with an overall 74% survival rate, and up to one-third of cases are due to congenital diaphragmatic hernia. The overall survival rate in cardiac ECMO is lower, with congenital heart defect representing the main indication. This review provides an overview of the available evidence in the field of neonatal ECMO. We will address the changing epidemiology, basic principles, technologic advances in circuitry, and monitoring, and deliver a current multidisciplinary management framework, focusing on ECMO applications, complications, and long-term morbidities. Lastly, areas for further research will be highlighted. Conclusions : ECMO is a life support with a potential impact on long-term patients’ outcomes. In the next years, advances in knowledge, technology, and expertise may push neonatal ECMO boundaries towards more premature and increasingly complex infants, with the final aim to reduce the burden of ECMO-related complications and improve overall patients’ outcomes. What is Known: • ECMO is a life-saving option in newborns with refractory respiratory and/or cardiac failure. • The multidisciplinary ECMO management is challenging and may expose neonates to complications with an impact on long-term outcomes. What is New: • Advances in technology and biomaterials will improve neonatal ECMO management and, eventually, the long-term outcome of these complex patients. • Experimental models of artificial placenta and womb technology are under investigation and may provide clinical translation and future research opportunities.

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“…5 Extracorporeal mechanical circulatory support in this population has also been described in a seven-patient case series. 6 None of the neonates <3 kg survived to hospital discharge. It is estimated that only 23% of neonates will fully recover ventricular function.…”

Section: Discussionmentioning

confidence: 94%