Clinical outcomes and experience of 20 pediatric patients treated with extracorporeal membrane oxygenation in Fuwai Hospital.
The purpose of this study was to report retrospectively the summarized clinical findings from 20 consecutive pediatric extracorporeal membrane oxygenation (ECMO) patients and to investigate the factors associated with mortality. The ECMO circuit system was completely covered using heparin-coating technique, and venoarterial ECMO was used in all patients. Heparin dosage was 4-20 U/kg/h and active clotting time was maintained between 146 and 360 seconds. ECMO was weaned off successfully in 15 patients (75%); 11 of 15 patients (73%) survived and were discharged from the hospital; 4 of 15 patients died of postoperative complications; 5 patients failed to be weaned off ECMO. The percentage of discharged patients was 55% (11 of 20) in this cohort study. Lactic acid concentration of artery blood before ECMO in survivor patients was significantly lower than in nonsurvivor patients (p = 0.009); patient weight between two groups also had statistical difference (p = 0.046). ECMO effectively treats cardiac and pulmonary failure secondary to cardiac surgeries for complicated congenital heart diseases. Early application of ECMO in patients with cardiac and respiratory failure is still the key point of success in preventing vital organs from irreversible damage.
Zhao
Ju
J
Department of Cardiopulmonary Bypass, Fuwai Cardiovascular Hospital, Chinese Academy of Medical Science, Peking Union Medical College, Beijing, People's Republic of China.
Liu
Jinping
J
Feng
Zhengyi
Z
Hu
Shengshou
S
Liu
Yinglong
Y
Sheng
Xiangdong
X
Li
Shoujun
S
Wang
Xu
X
Long
Cun
C
D000293:Adolescent; D002303:Cardiac Output, Low / Q000209:etiology / Q000628:therapy; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000379:methods / Q000401:mortality; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications / Q000601:surgery; D006333:Heart Failure / Q000209:etiology / Q000628:therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019344:Lactic Acid / Q000097:blood; D008297:Male; D012131:Respiratory Insufficiency / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome; D015300:Ventilator Weaning
D019344:Lactic Acid