Absence of rapid deployment extracorporeal membrane oxygenation (ECMO) team does not preclude resuscitation ecmo in pediatric cardiac patients with good results.
We evaluated the results of using extracorporeal membrane oxygenation (ECMO) as resuscitation for cardiac patients undergoing cardiopulmonary resuscitation (CPR) in our setting where neither perfusionists nor surgeons are always on site, and no circuit may be ready. Between 2003 and 2006, we used ECMO for all cardiac patients who underwent cardiac arrest in the pediatric intensive care unit (PICU) or Cath Laboratory. We reviewed retrospectively 14 consecutive files (15 episodes). Mean CPR time before ECMO institution was 44 minutes (10-110 minutes). The surgeons, perfusionist, and scrub nurse, not on site for three of these patients, had to be called in simultaneously with institution of CPR. Two died on ECMO, the third one was successfully transplanted after 5 days. Globally, 10 patients could be weaned (66%). Eight patients (57%) survived to hospital discharge, seven without obvious neurological damage. One patient was bridged to a left ventricular assist device (LVAD) and was eventually successfully transplanted. He had an ischemic brain lesion with good recuperation and no sequel. We obtained good results with resuscitation ECMO in our setting where a permanently on-site rapid deployment ECMO team is not present at all times.
Ghez
Olivier
O
Department of Thoracic and Cardiovascular Surgery, Children's Hospital La Timone, Marseille, France.
Fouilloux
Virginie
V
Charpentier
Arnaud
A
Fesquet
Patrick
P
Lion
Frederic
F
Lebrun
Lionel
L
Commandeur
Magali
M
Fraisse
Alain
A
Metras
Dominique
D
Kreitmann
Bernard
B
D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D016887:Cardiopulmonary Resuscitation; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000150:complications* / Q000401:mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008505:Medical Staff, Hospital; D008954:Models, Biological; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome