Prolonged extracorporeal organ support in a 2-year-old boy after cardiac surgery

Zobel, G; Dacar, D; Rigler, B; Berger, Johann; Metzler, H.

doi:10.1007/bf01720911

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…The sternum is left open with primary skin closure or covered with a sterile prosthetic sheet sutured to the skin edges. Definitive chest closure is performed within a few days postoperatively when hemodynamic stabilization has allowed a significant reduction in catecholamine support (21).…”

Section: Vascular Access and Cannulation Techniquesmentioning

confidence: 99%

Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

Wollenek

Czerny²,

Golej

1999

Artificial Organs

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Because children with severe myocardial dysfunction have limited therapeutic options, mechanical support of a failing heart is a matter of great interest. In the setting of cardiogenic shock or severe low cardiac output and hypoperfusion, extracorporeal membrane oxygenation (ECMO) can produce decisive improvements. The criteria for successful treatment include appropriate patient selection, improved surgical techniques and experience, higher recognition and anticipation of complications, and minimized delay in initiation of ECMO. Because the need for mechanical circulatory support may arise pre-, intra-, and postoperatively, every pediatric cardiac surgeon must be familiar with the principles and the surgical aspects of ECMO.

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Section: Vascular Access and Cannulation Techniquesmentioning

confidence: 99%

Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

Wollenek

Czerny²,

Golej

1999

Artificial Organs

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“…In our case, we suspect that the huge contusional hemorrhage of the LV resulted from the procedures used during open cardiac massage and ECMO cannulation. Hemorrhagic problems and bleeding control are always cumbersome issues during ECMO setup [1,2]. In this case in particular, the contusional wound of the myocardium kept oozing diffusely.…”

mentioning

confidence: 99%

A large postoperative left ventricular hemorrhagic contusion and management by prolonged mechanical circulatory support: a case report

et al. 2011

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Extracorporeal membrane oxygenation after cardiac arrest in children: what do we know?

Tajik

Cardarelli

2008

European Journal of Cardio-Thoracic Surgery

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The use of extracorporeal membrane oxygenation (ECMO) as a resuscitative measure during or after manual cardiopulmonary resuscitation (CPR) shows sharply contrasting results. To assess the added value of ECMO in this situation and looking for predictors of mortality we performed a meta-analysis of individual patients collected from observational studies. An electronic Pubmed search restricted to English language publications between 1990 and 2007 using a consensus restrictive criterion retrieved 462 titles. Of those, 93 abstracts were considered appropriate for full text evaluation with 37 articles being included in our meta-analysis. In addition, unpublished data on a series of 98 non-duplicated patients from the author of one of the included studies was added. Data on 288 individually identified patients with a median age of 0.50 years and a median weight was 4.5 kg and demonstrated an overall survival to hospital discharge of 39.6% (114/288). Neurological complications were common, affecting 27% of all patients (77/288) and 14% of those discharged alive (16/114). Other common complications were renal failure (25%) and sepsis (17%). Odds ratios for mortality were higher for the presence of: any complication (OR 3.9, 95% CL 2.3-6.4), neurological (OR 3.3, 95% CL 1.7-6.1), renal (OR 5.1, 95% CL 2.5-10.3) and when the implementation of ECMO took >30 min (OR 2.1, 95% CL 1.1-3.8). Neck vessels cannulation had a lower association with mortality (p<.001). Simple rate comparison between manual CPR alone and the use of emergency ECMO shows a difference on survival to discharge of 12-23%. Its effectiveness is higher when implemented in the first 30 min after arrest. Age and weight do not seem to influence mortality. The incidence of complications is high, particularly neurological and renal, having a strong influence on survival. The specific characteristics of the neurological complications and their long-term effects on survivors are poorly reported in the literature.

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Prolonged extracorporeal organ support in a 2-year-old boy after cardiac surgery

Cited by 3 publications

References 10 publications

Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

Surgical Aspects of Pediatric Cardiac Extracorporeal Membrane Oxygenation

A large postoperative left ventricular hemorrhagic contusion and management by prolonged mechanical circulatory support: a case report

Extracorporeal membrane oxygenation after cardiac arrest in children: what do we know?

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