Asistencia circulatoria mecánica en pediatría. Experiencia en el Hospital de Pediatría Dr. Juan P. Garrahan. Argentina

Moreno, Guillermo; Magliola, Ricardo; Pilan, María L; Althabe, María; Balestrini, M. R.; Lenz, Ana M; M, Krysnki; Rodríguez, Ricardo; Salgado, Gladys; Martin, Analía; Cardoso, Hugo Eckener Dantas de Pereira; Ruffa, P; Cornelis, C; Barreta, Jorge; Delucis, Pablo García

doi:10.1016/j.acmx.2013.12.009

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…It is well known that there is a considerable gap between excellence medical centers accomplishments and Latin America follow through [ 22 ] . Nevertheless, as in Brazil, some isolated efforts in Argentina and Colombia are noticed in this direction leading to promising results, as the recently published Garrahan's group initial experience with MCS [ 23 ] .…”

Section: Discussionmentioning

confidence: 99%

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Miana¹,

Silva²,

Canêo³

et al. 2018

Braz J Cardiovasc Surg

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IntroductionDonor shortage and organ allocation is the main problem in pediatric heart transplant. Mechanical circulatory support is known to increase waiting list survival, but it is not routinely used in pediatric programs in Latin America.MethodsAll patients listed for heart transplant and supported by a mechanical circulatory support between January 2012 and March 2016 were included in this retrospective single-center study. The endpoints were mechanical circulatory support time, complications, heart transplant survival and discharge from the hospital.ResultsTwenty-nine patients from our waiting list were assessed. Twelve (45%) patients were initially supported by extracorporeal membrane oxygenation (ECMO) and a centrifugal pump was implanted in 17 (55%) patients. Five patients initially supported by ECMO were bridged to another device. One was bridged to a centrifugal pump and four were bridged to Berlin Heart Excor®. Among the 29 supported patients, 18 (62%) managed to have a heart transplant. Thirty-day survival period after heart transplant was 56% (10 patients). Median support duration was 12 days (interquartile range [IQR] 4 - 26 days) per run and the waiting time for heart transplant was 9.5 days (IQR 2.5-25 days). Acute kidney injury was identified as a mortality predictor (OR=22.6 [CI=1.04-494.6]; P=0.04).ConclusionMechanical circulatory support was able to bridge most INTERMACS 1 and 2 pediatric patients to transplant with an acceptable complication rate. Acute renal failure increased mortality after mechanical circulatory support in our experience.

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Section: Discussionmentioning

confidence: 99%

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Miana¹,

Silva²,

Canêo³

et al. 2018

Braz J Cardiovasc Surg

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“…Historically, in Latin America (LATAM), ECMO was strongly related to cardiac surgery and the first step to start a MCS program . Therefore, the ECMO scenario in LATAM can help to understand the difficulties to have a well‐established MCS program in this region.…”

Section: The Latin‐american Elsomentioning

confidence: 99%

Pediatric Mechanical Circulatory Support Systems in Latin America

Canêo

Jatene

2016

Artificial Organs

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“…In 2006, we implemented an ECMO program for heart surgery. [6][7][8] The objective of this study was to describe the results of ECMO support in patients undergoing heart surgery and analyze the risk factors for morbidity and mortality in our population.…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal membrane oxygenation in pediatric cardiovascular care: Experience of a center in Argentina

et al. 2019

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Objective: To describe the results of extracorporeal membrane oxygenation in patients undergoing heart surgery and analyze the risk factors for morbidity and mortality. Methods: Retrospective study conducted in cardiac patients under circulatory support. Outcome measures, diagnosis, surgery, Risk Adjustment for Congenital Heart Surgery (RACHS) score, implantation time, cannulation, length of support during stay, complications, survival, and follow-up were recorded. Risks were analyzed in relation to age, weight, RACHS score, single-ventricle or biventricular disease, implantation time, length of support and stay, and complications. Descriptive statistical and logistic regression analyses for risk factors were done. Results: Among 5295 hospitalizations, 72 patients required extracorporeal membrane oxygenation (1.37 %). Median age: 6.5 months (interquartile range [IQR]: 20 days-2 years); weight: 5.5 kg (IQR: 3.25-9.5); pump time: 188 min (IQR: 134-246.5); clamp time: 92 min (65-117). Cannulation was done in the operating room in 34 cases (47 %). The median length of support was 3 days (IQR: 2-5), and of stay, 20 days (IQR: 11-32). Survival at discharge was 49 %; 8 patients died during follow-up. The most common complication was bleeding (57 %). Weight < 5 kg (p = 0.01) and vasopressor use during support (p = 0.012) were associated with a risk for mortality. The survival rate at 10 years was 77 %; 84 % of patients corresponded to functional class 1-2, and 37 % had some degree of developmental delay. Conclusions: The most common complication was bleeding; weight and vasopressor use were associated with mortality.

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Asistencia circulatoria mecánica en pediatría. Experiencia en el Hospital de Pediatría Dr. Juan P. Garrahan. Argentina

Cited by 4 publications

References 11 publications

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Rational Use of Mechanical Circulatory Support as a Bridge to Pediatric and Congenital Heart Transplantation

Pediatric Mechanical Circulatory Support Systems in Latin America

Extracorporeal membrane oxygenation in pediatric cardiovascular care: Experience of a center in Argentina

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