2019
DOI: 10.21037/jtd.2018.11.107
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Outcomes and factors associated with early mortality in pediatric and neonatal patients requiring extracorporeal membrane oxygenation for heart and lung failure

Abstract: Background: Mortality and morbidity after surgical repair for complex congenital heart defects and severe cardiopulmonary failure on extracorporeal membrane oxygenation (ECMO) support remain high despite significant advances in medical management and technological improvements. We report on outcomes and factors after using ECMO in our surgical pediatric population including short-and long-term survival. Methods: A total of 45 neonatal and pediatric patients were identified who needed ECMO in our department bet… Show more

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Cited by 20 publications
(12 citation statements)
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“…The risk of death is also very high. Analysis of Azizov et al showed that proper selection of patients using complications indexes may improve the results of treatment in this group of patients [9]. In the field of patient care during ECMO therapy, the key aspects are control of vital signs, patient observation to assess the risk of possible complications, but also cooperation with other members of the therapeutic team in diagnosing problems and undertaking rapid interventions.…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…The risk of death is also very high. Analysis of Azizov et al showed that proper selection of patients using complications indexes may improve the results of treatment in this group of patients [9]. In the field of patient care during ECMO therapy, the key aspects are control of vital signs, patient observation to assess the risk of possible complications, but also cooperation with other members of the therapeutic team in diagnosing problems and undertaking rapid interventions.…”
Section: Discussionmentioning
confidence: 99%
“…Analiza Azizov i wsp贸艂. wykaza艂a, 偶e odpowiednia selekcja pacjent贸w za pomoc膮 wska藕nik贸w powik艂a艅 mo偶e poprawi膰 wyniki leczenia tej grupy chorych [9]. W zakresie Zuzanna Strz膮ska-Kli艣, Natalia Pawlak, Katarzyna Lis, Anna Bobrowska, Gilbert Kolbe, Paulina Pergo艂, Lena Serafin piel臋gnacji chorego w trakcie terapii z wykorzystaniem ECMO kluczowymi aspektami s膮 kontrola parametr贸w 偶yciowych, obserwacja pacjenta w celu oceny ryzyka wyst膮pienia ewentualnych powik艂a艅, ale tak偶e wsp贸艂praca z innymi cz艂onkami zespo艂u terapeutycznego w zakresie diagnozowania problem贸w oraz podejmowania szybkich interwencji.…”
Section: Dyskusjaunclassified
“…Tissue microdialysis was not conducted due to its invasiveness and costs. Main characteristics, criteria and technique of vaECMO assistance in neonatal and pediatric patients have been published in detail in previous studies [7][8][9][10][11]. Target activated clotting time was 160-180 s, whereas activated partial thromboplastin time (aPTT) was maintained by 60-80 s., based on daily controls if there was no active bleeding tendency.…”
Section: Methodsmentioning
confidence: 99%
“…We are surprised that 41% analyzed patients received no inotropic agents while as stated by the authors these agents aim to secure left ventricular ejection in order to decrease the risk of intra-cardiac stasis [2] in patients benefiting from VA-ECMO for cardiogenic shock or cardiac arrest. The norepinephrine dose requirement reflects the severity of the underlying hemodynamic failure despite VA-ECMO, independently of the associated inotropic agent [3]. We cannot exclude a selection bias; patients with a higher risk of unfavorable evolution are those requiring higher doses of catecholamines including epinephrine.…”
mentioning
confidence: 99%
“…This does however not necessarily mean that outcome in patients on VA-ECMO can be improved by inotropic therapy, and therefore has to be evaluated. Same holds true for generalizing retrospective data on norepinephrine dose derived from pediatric and neonatal patients [3] to adults, or for data from patients after out-of-hospital cardiac arrest [4] to a collective of mixed in-hospital and out-of-hospital arrest patients after extracorporeal resuscitation (eCPR). While randomized trials on VA-ECMO in patients with cardiogenic shock [5] are in dire need, they will not answer the pressing questions concerning Authors' response Viviane Zotzmann, Daniel Duerschmied and Dawid L. Staudacher optimal treatment of patients put on VA-ECMO.…”
mentioning
confidence: 99%