Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery

Kolovos, Nikoleta S.; Bratton, Susan L.; Moler, Frank W.; Bove, Edward L.; Ohye, Richard G.; Bartlett, Robert H.; Kulik, Thomas J.

doi:10.1016/s0003-4975(03)00898-1

Cited by 188 publications

(192 citation statements)

References 15 publications

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“…PDA, patent ductus arteriosus; PFO, patent foramen ovale; PHTN, pulmonary hypertension; PI, pulmonary insufficiency; RV, right ventricle; S/P, status post; TAPVC, total anomalous pulmonary venous connection; TGA, transposition of great arteries; TOF, tetralogy of Fallot; TR, tricuspidal regurgitation; TV, tricuspidal valve; TVR, tricuspidal valve regurgitation; VSD, ventricular septal defect. RACHS-1 risk for in-hospital death, see classification in Jenkins et al (16) mortality in our study was the lowest pH value while on ECMO, which is consistent with a study (13) that showed that the highest lactate level within 48 hours on ECMO predicted death. Intuitively, the type of heart defect or completeness of surgical repair could affect the survival.…”

Section: Discussionsupporting

confidence: 92%

“…However, the completeness of repair was not a significant factor for either ECMO weaning or survival in our patients. Kolovos et al (13) reported that children who received ECMO after an adequate two-ventricular repair (biventricular physiology) had lower risk of death compared to those with single ventricle physiology. In contrast, another study reported 61% survival to discharge in infants with univentricular physiology, compared with 43% in those with biventricular physiology.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric surgical extracorporeal membrane oxygenation -a case series

Flick

Gleich

Hanson

et al. 2008

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Pediatric surgical extracorporeal membrane oxygenation -a case series

Flick

Gleich

Hanson

et al. 2008

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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 cardiopulmonary support with membrane oxygenator has been used with some satisfactory results in large world centers for years [1][2][3][4][5][6] . In our country, its development and clinical application are limited, being restricted to a few high-complexity centers 8 .…”

Section: Discussionmentioning

confidence: 99%

“…The large experience acquired as well as the increasing progress in this area in international centers [1][2][3][4][5][6] has directed the development of this method in our country.…”

Section: Introductionmentioning

confidence: 99%