Extracorporeal membrane oxygenation for perioperative cardiac support in children I: experience at the Deutsches Herzzentrum Berlin (1987-2005).
We report our experience in pediatric patients supported by extracorporeal membrane oxygenation (ECMO) for perioperative circulatory failure from January 1987 to June 2005. Pediatric patients (n = 110) who had ECMO support for congenital heart defects, myocarditis, and cardiomyopathy (age range, newborn to 18 years; weight range, 2.3-69 kg) were included and divided into three groups based on timing of ECMO support. EMCO support was used preoperatively in 21 patients (19.1%) (mean age, 4 years +/- 8 months; mean weight, 23.7 +/- 8.9 kg). Duration of ECMO support was 8.3 +/- 7 days. Fifty-six patients (56.56%) (mean age, 5.11 +/- 5 years; mean weight, 15.7 +/- 6.9 kg) had intraoperative ECMO support for myocardial insufficiency, low output syndrome, right ventricular failure, left ventricular failure, malignant arrhythmia, pulmonary hypertension, and repeated resuscitation. Mean duration of ECMO support was 4.98 +/- 1 days. Postoperative ECMO support was used in 29 patients (mean age, 7.5 +/- 1 years; mean weight, 23.4 +/- 6.4 kg). Mean duration of ECMO was 4.6 +/- 1 days. Mean postoperative day of ECMO institution was 40.4 +/- 2 days. Our experience shows that ECMO support can be offered perioperatively to any patient with potentially reversible pulmonary, cardiac, or cardiopulmonary failure, excluding those whose outcome is inevitable.
Delmo Walter
Eva Maria
EM
Department of Cardiothoracic and Vascular Surgery, Deutsches Herzzentrum Berlin, Germany.
Stiller
Brigitte
B
Hetzer
Roland
R
Alexi-Meskishvili
Vladmir
V
Hübler
Michael
M
Böttcher
Wolfgang
W
Berger
Felix
F
D000293:Adolescent; D009202:Cardiomyopathies / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000295:instrumentation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007430:Intraoperative Care; D008297:Male; D009205:Myocarditis / Q000150:complications / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome