Pediatric ventricular assist device therapy for advanced heart failure-Hong Kong experience

Bhatia, Inderjeet; Ho, Ka-Lai Cally; Rocha, Barnabe Antonio; Yam, Nicholson; Lun, Kin‐Shing; Yung, TC; Au, Wing-Kuk Timmy

doi:10.1007/s10047-019-01140-4

Cited by 5 publications

(2 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Certainly, patients requiring ECMO often possess many known comorbidities and risk factors for AKI, such as low cardiac output, septic shock, anemia, diabetes, exposure to nephrotoxic drugs, etc. [30,31]. In general, there are fewer comorbidities among pediatric patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

et al. 2019

View full text Add to dashboard Cite

Background: Acute kidney injury (AKI) is a well-established complication of extra-corporal membrane oxygenation (ECMO) in the adult population. The data in the pediatric and neonatal population is still limited. Moreover, the mortality risk of AKI among pediatric patients requiring ECMO remains unclear. Thus, this meta-analysis aims to assess the incidence of AKI, AKI requiring renal replacement therapy and AKI associated mortality in pediatric/neonatal patients requiring ECMO. Methods: A literature search was performed utilizing MEDLINE, EMBASE, and the Cochrane Database from inception through June 2019. We included studies that evaluated the incidence of AKI, severe AKI requiring renal replacement therapy (RRT) and the risk of mortality among pediatric patients on ECMO with AKI. Random-effects meta-analysis was used to calculate the pooled incidence of AKI and the odds ratios (OR) for mortality. Results: 13 studies with 3523 pediatric patients on ECMO were identified. Pooled incidence of AKI and AKI requiring RRT were 61.9% (95% confidence interval (CI): 39.0–80.4%) and 40.9% (95%CI: 31.2–51.4%), respectively. A meta-analysis limited to studies with standard AKI definitions showed a pooled estimated AKI incidence of 69.2% (95%CI: 59.7–77.3%). Compared with patients without AKI, those with AKI and AKI requiring RRT while on ECMO were associated with increased hospital mortality ORs of 1.70 (95% CI, 1.38–2.10) and 3.64 (95% CI: 2.02–6.55), respectively. Conclusions: The estimated incidence of AKI and severe AKI requiring RRT in pediatric patients receiving ECMO are high at 61.9% and 40.9%, respectively. AKI among pediatric patients on ECMO is significantly associated with reduced patient survival.

show abstract

Section: Discussionmentioning

confidence: 99%

“…However, it is proposed that ECMO itself is capable of inducing AKI via detrimental (1) hemodynamic alterations; (2) hormonal imbalances; and (3) systemic inflammatory cytokines [11,30,31]. Hemodynamic alterations may include the potential loss of pulsatility with VA ECMO versus the maintenance of pulsatility with VV ECMO.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

et al. 2019

View full text Add to dashboard Cite

show abstract

The importance of mechanical circulatory support on pediatric waitlist and post heart transplant survival: a narrative review

Bearl¹

2022

Pediatr Med

View full text Add to dashboard Cite

Mechanical circulatory support devices and treatment strategies for right heart failure

Kuroda

Miyagi

Fukamachi

et al. 2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

The importance of right heart failure (RHF) treatment is magnified over the years due to the increased risk of mortality. Additionally, the multifactorial origin and pathophysiological mechanisms of RHF render this clinical condition and the choices for appropriate therapeutic target strategies remain to be complex. The recent change in the United Network for Organ Sharing (UNOS) allocation criteria of heart transplant may have impacted for the number of left ventricular assist devices (LVADs), but LVADs still have been widely used to treat advanced heart failure, and 4.1 to 7.4% of LVAD patients require a right ventricular assist device (RVAD). In addition, patients admitted with primary left ventricular failure often need right ventricular support. Thus, there is unmet need for temporary or long-term support RVAD implantation exists. In RHF treatment with mechanical circulatory support (MCS) devices, the timing of the intervention and prediction of duration of the support play a major role in successful treatment and outcomes. In this review, we attempt to describe the prevalence and pathophysiological mechanisms of RHF origin, and provide an overview of existing treatment options, strategy and device choices for MCS treatment for RHF.

show abstract

Pediatric ventricular assist device therapy for advanced heart failure-Hong Kong experience

Cited by 5 publications

References 34 publications

Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

Acute Kidney Injury in Pediatric Patients on Extracorporeal Membrane Oxygenation: A Systematic Review and Meta-analysis

The importance of mechanical circulatory support on pediatric waitlist and post heart transplant survival: a narrative review

Mechanical circulatory support devices and treatment strategies for right heart failure

Contact Info

Product

Resources

About