Extracorporeal Membrane Oxygenation in Postcardiotomy Pediatric Patients—15 Years of Experience Outside Europe and North America

Ahmed F. ElMahrouk; Mohamed Fouad Ismail; Tamer Hamouda; Rafik Shaikh; Alaa Mahmoud; Mohammad Sabry Shihata; Osman Alradi; Ahmed Jamjoom

doi:10.1055/s-0037-1608962

The Thoracic and Cardiovascular Surgeon, Inhaltsverzeichnis

Thorac Cardiovasc Surg 2019; 67(01): 028-036
DOI: 10.1055/s-0037-1608962

Original Cardiovascular

Georg Thieme Verlag KG Stuttgart · New York

Extracorporeal Membrane Oxygenation in Postcardiotomy Pediatric Patients—15 Years of Experience Outside Europe and North America

Ahmed F. ElMahrouk

¹Department of Cardiothoracic Surgery, Tanta University Faculty of Medicine, Tanta, Egypt

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

,

Mohamed Fouad Ismail

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

³Department of Cardiothoracic Surgery, Mansoura University Faculty of Medicine, Mansoura, Egypt

,

Tamer Hamouda

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

⁴Department of Cardiothoracic Surgery, Benha University Faculty of Medicine, Benha, Egypt

,

Rafik Shaikh

⁵Department of Cardiothoracic Surgery, Perfusion Services, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

,

Alaa Mahmoud

¹Department of Cardiothoracic Surgery, Tanta University Faculty of Medicine, Tanta, Egypt

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

,

Mohammad Sabry Shihata

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

,

Osman Alradi

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

⁶Department of Surgery, King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia

,

Ahmed Jamjoom

²Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia

› Institutsangaben

Abstract

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Abstract

Background The increasing complexity of congenital cardiac surgery has resulted in the increased use of extracorporeal membrane oxygenation (ECMO) support for children who cannot be weaned from cardiopulmonary bypass. The purpose of this research was to assess the mortality and morbidity in children requiring ECMO support after the repair of congenital heart defects (CHDs).

Methods The hospital records of all patients with CHD who required ECMO after a cardiac surgical procedure between January 2001 and December 2016 were retrospectively reviewed. Various outcomes were reported and tested for any association with hospital death.

Results A total of 113 children required ECMO for cardiopulmonary support after congenital cardiac surgery; 88 (77.9%) were placed on ECMO in the operating room. Median age of the patients was 3 months (range, 4 days–15 years) and median weight was 3.5 kg (range, 2.2–42.5). Forty-two (37.2%) survived to hospital discharge. In children with single-ventricle physiology, survival to discharge was 37.3% (19/51 patients) and for biventricular physiology, it was 37.1% (23/62 patients). Univariate analysis revealed number of days on ECMO support, renal failure, and stroke as risk factors for hospital mortality, while age and cross-clamp time were found to be statistically nonsignificant.

Conclusion Satisfactory results can be achieved in pediatric patients by using ECMO support for postoperative cardiac and pulmonary failure refractory to medical management. Prolonged ECMO support, renal failure, and stroke are risk of mortality.

Keywords

extracorporeal membrane oxygenation - congenital heart disease - pediatric - cardiac surgery

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Referenzen

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