Is there a role for extracorporeal life support after stage I Norwood?

Pizarro, Christian; Davis, Deborah A.; Healy, Regina M.; Kerins, Paul; Norwood, William I.

doi:10.1016/s1010-7940(01)00575-9

Cited by 68 publications

(49 citation statements)

References 12 publications

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“…ECMO duration and impact on survival following ECPR remain controversial and results varied [16,17,[19][20][21][22]. Consistent with other studies [11,16,17], ECMO duration was statistically different in the ECPR survivors compared with non-survivors.…”

Section: Discussionsupporting

confidence: 78%

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Post-cardiotomy extracorporeal cardiopulmonary resuscitation in neonates with complex single ventricle: analysis of outcomes

Polimenakos¹,

Wojtyla²,

Smith³

et al. 2011

European Journal of Cardio-Thoracic Surgery

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ECMO support in neonates with FSV requiring ECPR can result in favorable outcome in more than half of patients at hospital discharge. Aggressive strategy toward timely application of ECPR is justified. Expeditious ECPR deployment after proper patients' selection, refinement of CPR quality and use of adjunctive neuroprotective interventions, such as induced hypothermia, might further improve outcomes.

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Section: Discussionsupporting

confidence: 78%

“…Furthermore, as reported [22], survival is extremely poor when patients were placed on extracorporeal support out of the OR. Early institution of ECMO support in the OR was associated with a better chance of survival to hospital discharge in patients with single-ventricle physiology.…”

Section: Discussionmentioning

confidence: 85%

Post-cardiotomy extracorporeal cardiopulmonary resuscitation in neonates with complex single ventricle: analysis of outcomes

Polimenakos¹,

Wojtyla²,

Smith³

et al. 2011

European Journal of Cardio-Thoracic Surgery

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“…Many studies have shown that renal failure is an independent predisposing factor for increased mortality. [11][12][13][14][15] dynamics of a patient cannot be improved with PCPS and if PCPS flow can not be reduced at most by 96 hours after the induction of PCPS, it may be difficult to wean them from PCPS, and other cardiac support such as a ventricular assist device (VAD) and/or heart transplantation may be required in such 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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“…The ECMO in neonates with single-ventricle defects is applied due to low cardiac output, cardiac arrest, or ventricular dysfunction after surgical procedures [3,4]. We have described a rare situation in which ECMO support was applied due to pulmonary insufficiency of unclear cause, most likely a combination of high pulmonary vascular resistance and pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Veno-venous ECMO for carbon dioxide removal in a neonate after Norwood operation with an RV-PA shunt

Mroczek¹,

Jarosz²,

Stycuła³

et al. 2013

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StreszczenieW pracy opisano przypadek noworodka z wrodzoną wadą serca o typie pojedynczej komory serca, u którego we wczesnym okresie po operacji sposobem Norwooda z zespoleniem prawa komora-tętnica płucna zastosowano z powodzeniem żyl-no-żylne pozaustrojowe wspomaganie układu oddechowego (extracorporeal membrane oxygenation -ECMO). Słowa kluczowe: ECMO żylno-żylne, operacja Norwooda. Kardiochirurgia i Torakochirurgia Polska 2013; 10 (2) 165Case reports AbstractWe describe a case of a newborn with a single-ventricle congenital heart defect, in which veno-venous extracorporeal membrane oxygenation (ECMO) was successfully employed shortly after a Norwood operation with right ventricle-to-pulmonary artery shunt due to pulmonary insufficiency.

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Is there a role for extracorporeal life support after stage I Norwood?

Abstract: Although the use of ECLS in patients with single ventricle physiology still carries a significant risk, prompt initiation of support can improve the outcome in a group of patients with impaired cardiopulmonary function after stage I palliation.

Cited by 68 publications

References 12 publications

Post-cardiotomy extracorporeal cardiopulmonary resuscitation in neonates with complex single ventricle: analysis of outcomes

Post-cardiotomy extracorporeal cardiopulmonary resuscitation in neonates with complex single ventricle: analysis of outcomes

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

Veno-venous ECMO for carbon dioxide removal in a neonate after Norwood operation with an RV-PA shunt

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