title: Rapid cardiopulmonary support for children with complex congenital heart disease.
abstract: BACKGROUND
  Extracorporeal membrane oxygenation has limitations in children with congenital heart disease (prolonged setup times, increased postoperative blood loss, and difficulty during transport). We developed a miniaturized cardiopulmonary support circuit to address these limitations.
  
  
  METHODS
  The cardiopulmonary support system includes a preassembled, completely heparin-coated circuit, a BP-50 Bio-Medicus centrifugal pump, a Minimax plus membrane oxygenator, a Bio-Medicus flow probe, and a Bio-trend hematocrit/oxygen saturation monitor. Short tubing length permits a 250-mL bloodless prime in less than 5 minutes. From 1995 to 1997, 23 children with congenital heart disease were supported with this technique.
  
  
  RESULTS
  Overall survival to discharge was 48% (11 of 23 patients). Survival to discharge was 80% (4 of 5) in the preoperative support group, 20% (1 of 5) in the postoperative failure to wean from cardiopulmonary bypass group, 44% (4 of 9) in the group placed on support postoperatively after transfer to the intensive care unit, and 50% (2 of 4 patients) in the nonoperative group. Neonatal cardiopulmonary support survival to discharge was 46% (6 of 13 patients).
  
  
  CONCLUSIONS
  This pediatric cardiopulmonary support system is safe and effective. Advantages over conventional extracorporeal membrane oxygenation include rapid setup time, decreased postoperative blood loss, and simplified transport.
authors.affiliation: Division of Cardiovascular Surgery, Miami Children's Hospital, Florida, USA. jjacobs1@compuserve.com
authors.forename: J P
authors.initials: JP
authors.lastname: Jacobs
authors.forename: J W
authors.initials: JW
authors.lastname: Ojito
authors.forename: T W
authors.initials: TW
authors.lastname: McConaghey
authors.forename: B D
authors.initials: BD
authors.lastname: Boden
authors.forename: A C
authors.initials: AC
authors.lastname: Chang
authors.forename: A
authors.initials: A
authors.lastname: Aldousany
authors.forename: E M
authors.initials: EM
authors.lastname: Zahn
authors.forename: R P
authors.initials: RP
authors.lastname: Burke
mesh_terms: D001803:Blood Transfusion; D002315:Cardiopulmonary Bypass / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D004867:Equipment Design; D005069:Evaluation Studies as Topic; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D014187:Transportation of Patients; D016896:Treatment Outcome