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 5295hospitalizations, 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: 134246.5); 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: 1132). 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.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.5546/aap.2019.eng.157 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
ECMO-assisted bilateral uniportal thoracoscopic carinal resection and reconstruction: a case report.
J Cardiothorac Surg
January 2025
Department of Thoracic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Background: Carinal resection and reconstruction are complex surgical procedures often necessitated by tumors or other pathologies involving the tracheobronchial junction. Traditional approaches to these surgeries are highly invasive. The advent of uniportal video-assisted thoracoscopic surgery (VATS) along with the integration of extracorporeal membrane oxygenation (ECMO) offer potential advantages in reducing surgical trauma and improving outcomes.
View Article and Find Full Text PDFEarly Left Ventricular Unloading after Venoarterial Extracorporeal Membrane Oxygenation: One-Year Outcomes of the EARLY-UNLOAD Randomized Clinical Trial.
Eur Heart J Acute Cardiovasc Care
January 2025
Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea.
Background: The long-term effects of early left ventricular unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.
Methods: The EARLY-UNLOAD trial was a single-center, investigator-initiated, open-label, randomized clinical trial involving 116 patients with cardiogenic shock (CS) undergoing VA-ECMO. The patients were randomly assigned to undergo either early routine left ventricular unloading by transseptal left atrial cannulation within 12 hours after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased left ventricular afterload.
'Real-life' approach to applying PK/PD principles in infectious diseases clinical practice without access to prompt TDM.
Expert Rev Anti Infect Ther
January 2025
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy.
Introduction: Infectious disease treatments are transitioning from a one-size-fits-all approach to a more tailored approach. The increasing adoption of therapeutic drug monitoring (TDM) of antimicrobials is a clear example of this trend. Routine antimicrobial TDM in critically ill patients should be mandatory.
View Article and Find Full Text PDFMechanical Circulatory support for Septic Shock in Children and Adults: Different but Similar!
Can J Cardiol
December 2024
Senior Consultant Intensive Care, Royal Childrens Hospital, Melbourne, Australia; Professor Department of Critical Care, Faculty of Medicine, Melbourne University.
Whilst Extra-Corporeal Membrane Oxygenation (ECMO) for circulatory support in patients with severe septic shock, commenced in newborn infants and children in the late 1980's, ECMO has remained a controversial treatment for adults with refractory septic shock (RSS). This is fundamentally due to differences in the predominant hemodynamic response to sepsis. In newborn infants and very young children ventricular failure called Low Cardiac Output Syndrome (LCOS) is the major hemodynamic response whilst adolescents and adults have mainly vasoplegic shock.
View Article and Find Full Text PDFEffect of extracorporeal membrane oxygenation on mortality rate of aluminum phosphate poisoning: A systematic review and meta-analysis.
J Res Med Sci
October 2024
Department of Clinical Toxicology, Isfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: Aluminum phosphate (ALP) poisoning has a high mortality rate (MR) secondary to cardiogenic shock. Recently, extracorporeal membrane oxygenation (ECMO) showed a successful result in this issue. We conducted a systematic review and meta-analysis to compare the MR of patients with ALP poisoning who underwent ECMO versus those with conventional treatment.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!