title: Extracorporeal membrane oxygenation in pediatric patients: our experience in the last ten years.
abstract: BACKGROUND
  The use of extracorporeal membrane oxygenation (ECMO) in children after cardiac surgery is well established. ECMO support is becoming an integral tool for cardiopulmonary resuscitation in specified centers.
  
  
  OBJECTIVE
  To review our use of ECMO over a 10 year period.
  
  
  METHODS
  All children supported with ECMO from 2000 to 2010 were reviewed. Most of these children suffered from cardiac anomalies. The patients were analyzed by age, weight, procedure, RACHS-1 when appropriate, length of support, and outcome.
  
  
  RESULTS
  Sixty-two children were supported with ECMO; their median age was 3 months (range 0-216 months) and median weight 4.3 kg (range 1.9-51 kg). Thirty-four patients (52.3%) needed additional hemofiltration or dialysis due to renal failure. The children requiring ECMO support represented a wide spectrum of cardiac lesions; the most common procedure was arterial switch operation (27.4%, n=17). ECMO was required mainly for failure to separate from the heart-lung machine (n=55). The median duration of ECMO support was 4 days (range 1-14 days); 29 (46.7%) patients were weaned successfully from ECMO during this time period, and 5 of them died during hospitalization, yielding an overall hospital survival rate of 38.7%.
  
  
  CONCLUSIONS
  ECMO support has significant survival benefit for patients with post-cardiotomy heart failure. Its early deployment should be considered in cardiopulmonary resuscitation.
authors.affiliation: Department of Cardiothoracic Surgery, Wolfson Medical Center, Holon, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. dawn@wolfson.health.gov.il
authors.forename: Lior
authors.initials: L
authors.lastname: Sasson
authors.forename: Ilan
authors.initials: I
authors.lastname: Cohen
authors.forename: Akiva
authors.initials: A
authors.lastname: Tamir
authors.forename: Alona Raucher
authors.initials: AR
authors.lastname: Sternfeld
authors.forename: Yitzhak
authors.initials: Y
authors.lastname: Berlowitz
authors.forename: Orit
authors.initials: O
authors.lastname: Lenczner
authors.forename: Sion
authors.initials: S
authors.lastname: Houri
mesh_terms: D006348:Cardiac Surgical Procedures; D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000401:mortality / Q000601:surgery*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007557:Israel / Q000453:epidemiology; D008297:Male; D011182:Postoperative Care / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors