Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation*

Morris, Marilyn C.; Ittenbach, Richard F.; Godinez, Rodolfo I.; Portnoy, Joel D.; Tabbutt, Sarah; Hanna, Brian D.; Hoffman, Timothy M.; Gaynor, J. William; Connelly, James; Helfaer, Mark A.; Spray, Thomas L.; Wernovsky, Gil

doi:10.1097/01.ccm.0000119425.04364.cf

Cited by 173 publications

(159 citation statements)

References 25 publications

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“…In a previous study, we identified MOF as an independent predictor of fatal outcome in patients with severe heart failure. 8) Morris, et al 9) also reported that development of renal or hepatic dysfunction while patients were on PCPS was a factor associated with an increased probability of mortality in postoperative patients requiring PCPS. Hoskote, et al 10) found that multiple organ system failure was a significant risk factor for poor outcome among the nonsurvivors receiving PCPS after surgery in functional single ventricle patients.…”

Section: Discussionmentioning

confidence: 99%

Factors for Successful Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Low Cardiac Output Syndrome After Cardiovascular Surgery

et al. 2007

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SUMMARYThe objective of this study was to analyze the early predictive factors for successful weaning from a percutaneous cardiopulmonary support system (PCPS) in patients with low cardiac output syndrome after cardiovascular surgery.A total of 938 patients underwent cardiovascular surgery with cardiopulmonary bypass (CPB) from January 1991 to September 2006 at Gunma University Hospital. Of these 938 patients, 13 (1.4%) required PCPS to maintain hemodynamics within 48 hours after surgery. The mean age of the 13 patients was 66 years (range, 45 to 86 years). Nine patients underwent open-heart surgery, 3 repair of a thoracic aortic aneurysm, and 1 a pericardiectomy. The patients were divided into 2 groups; group A (n = 4) who were removed from PCPS and group B (n = 9) who were not removed from PCPS. The conditions during the operation and after PCPS support were compared between the 2 groups.The mean age was higher, and operation time, CPB time, and aortic cross-clamping time were significantly (P < 0.05) longer in patients with PCPS than in those without PCPS. The mean PCPS time in all 13 patients was 190 ± 122 hours. The mean age was higher, and CPB time and the aortic cross-clamping time were longer in group B than in group A (NS). The mean duration of PCPS support was significantly (P < 0.05) shorter in group A than in group B (117 ± 42 hours versus 235 ± 136 hours). PCPS flow in group A could be reduced from 48 hours after PCPS induction. However, PCPC flow in group B could not be reduced, and there were significant (P < 0.05) differences in PCPS flow at 72 and 96 hours after starting PCPS. Significant (P < 0.05) differences in the absolute values of the APACHE II score, serum lactate levels, administered epinephrine dose, and levels of total bilirubin (T-Bil), serum creatinine (sCr), and lactate dehydrogenase (LDH) were found between the 2 groups within 96 hours after PCPS induction. In addition, there were significant (P < 0.05) differences in the rate of change compared with the baseline control value obtained prior to PCPS use in PCPS flow, APACHE II score, and levels of T-Bil, sCr, and LDH within 96 hours after PCPS induction. Significant differences in the rate of change of sCr and LDH were found, especially from the early phase after PCPS use, compared with other parameters.From the

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Section: Discussionmentioning

confidence: 99%

Factors for Successful Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Low Cardiac Output Syndrome After Cardiovascular Surgery

et al. 2007

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“…In older patients, survival was better, 47% to 49% in patients 31 days to 1 year of age and 58% to 59% December 17, 2013 in patients 1 to 16 years of age, and is consistent with large single-center experiences. 494,495 Like CPB, ECMO exposes the blood to a large surface area of foreign material and would result in thrombus formation if not for the use of anticoagulation. Bleeding complications are common, and despite anticoagulation, thrombotic and thromboembolic complications are also common on ECMO.…”

Section: Anticoagulation For Cardiac Ecmo In Children With Chdmentioning

confidence: 99%

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Giglia¹,

Massicotte²,

Tweddell³

et al. 2013

Circulation

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297

245

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“…[20] Many factors including baseline ECMO clinical status, diagnosis, cardiac surgical procedures, timing of initiation of ECMO and ECMO-related factors may affect outcomes for postcardiotomy patients supported with ECMO. The risk factors associated with mortality in children who were supported with ECMO after cardiac surgery were described by Morris et al [21] These risk factors were age below one month, male gender, longer duration of mechanical ventilation before support, and development of renal or hepatic dysfunction while on support. However, functional cardiac physiology (univentricular or biventricular), ECMO indications, and duration of ECMO were not found to be associated with an increased risk of mortality.…”

Section: Discussionmentioning

confidence: 99%

Extracorporeal membrane oxygenation support after pediatric cardiac surgery: our single-center experience

Yüksel¹

2017

Turk Gogus Kalp Dama

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ÖZAmaç: Bu çalışmada, pediyatrik açık kalp cerrahisi sonrası mekanik destek gereken hastalarda beş yıllık ekstrakorporeal membran oksijenasyonu deneyimimiz sunuldu.Ça lış mapla nı:Şubat 2010 -Mart 2015 tarihleri arasında açık kalp cerrahisi yapılan ve postkardiyotomi dolaşım yetmezliği nedeniyle ekstrakorporeal membran oksijenasyonu desteği gereken 29 çocuğun (16 erkek, 13 kız; ort. yaş 21.6 ay; dağılım 5 gün-162 ay) tıbbi kayıtları retrospektif olarak incelendi. Bul gu lar:En sık tanı, sekiz hastada (%27.5) Fallot tetralojisi idi. En sık ekstrakorporeal membran oksijenasyonu endikasyonu, 12 hastada (%41) kardiyopulmoner baypastan ayrılmada yetersizlik idi. Ortalama ekstrakorporeal membran oksijenasyonu destek süresi 6.9 gündü (dağılım 14 saat-32 gün). En sık görülen ekstrakorporeal membran oksijenasyonu ile ilişkili komplikasyon, 14 hastada (%48.3) böbrek yetmezliği idi. On dört hasta (%48.3) başarıyla ekstrakorporeal membran oksijenasyonu desteğinden ayrılırken, altı hasta (%20.7) herhangi bir nörolojik sekel olmaksızın hastaneden taburcu edildi. Hiç bir anlamlı bir mortalite öngördürücüsü bulunmadı. Kardiyopulmoner baypastan ayrılmada yetersizlik, diğer ekstrakorporeal membran oksijenasyonu endikasyonlarına kıyasla, daha iyi sonuçlar ile neticelendi.So nuç: Ekstrakorporeal membran oksijenasyonu, pediyatrik açık kalp cerrahisi sonrasında etkili bir kardiyopulmoner desteği sağlar. Dikkatli hasta seçimi ve ekstrakorporeal membran oksijenasyonu için doğru zamanlama ve uygun tedavi optimum sonuçlar için çok önemlidir.Anah tar söz cük ler: Ekstrakorporeal membran oksijenasyonu; mekanik destek; pediyatrik kalp cerrahisi; postkardiyotomi dolaşım yetmezliği; venoarteriyel. ABSTRACTBackground:In this study, we present our five-year extracorporeal membrane oxygenation experiences in patients requiring mechanical support after pediatric open heart surgery.

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Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation*

Cited by 173 publications

References 25 publications

Factors for Successful Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Low Cardiac Output Syndrome After Cardiovascular Surgery

Factors for Successful Weaning From a Percutaneous Cardiopulmonary Support System (PCPS) in Patients With Low Cardiac Output Syndrome After Cardiovascular Surgery

Prevention and Treatment of Thrombosis in Pediatric and Congenital Heart Disease

Extracorporeal membrane oxygenation support after pediatric cardiac surgery: our single-center experience

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