title: Impact of extracorporeal membrane oxygenation support on clinical outcome of pediatric patients with acute cardiopulmonary failure: a single-center experience.
abstract: BACKGROUND
  Conventional therapy against acute pediatric cardiopulmonary failure (APCPF) caused by a variety of disease entities remains unsatisfactory with extremely high morbidity and mortality. For refractory APCPF, extracorporeal membrane oxygenation (ECMO) is one of the last resorts.
  
  
  METHODS
  In this study, the in-hospital outcomes of pediatric patients with refractory APCPF receiving ECMO support were reviewed.
  
  
  RESULTS
  Between August 2006 and May 2011, a single-center cohort study was performed in pediatric patients who required ECMO support due to cardiogenic shock or severe hypoxemia. A total of 22 patients with mean age of 7.0 ± 6.3 years received ECMO (male = 11; female = 11). The indications included acute fulminant myocarditis (AFM) (n = 6), congenital diaphragmatic hernia (CDH) (n = 3), acute respiratory distress syndrome (ARDS) (n = 6), enterovirus 71 (n = 3), viral sepsis (n = 2), refractory ventricular fibrillation due to long QT syndrome (n = 1), and pulmonary edema with brain herniation (n = 1). Eighteen patients received veno-arterial (VA) mode ECMO, while another four patients undertook the veno-venous (VV) mode. The duration of ECMO use and hospitalization were 6.1 ± 3.1 and 24.4 ± 19.4 days, respectively. The survival rate in patients with AFM was 100% (n = 6). Successful ECMO weaning with uneventful discharge from hospital was noted in 14 (63.6%) patients, whereas in-hospital mortality despite successful ECMO weaning occurred in 5 patients (22.7%). Failure in ECMO weaning and in-hospital death was noted in 3 patients (13.6%).
  
  
  CONCLUSIONS
  ECMO resuscitation is an effective strategy in the clinical setting of APCPF.
authors.affiliation: Division of Cardiology, Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Ying-Jui
authors.initials: YJ
authors.lastname: Lin
authors.forename: Sheng-Ying
authors.initials: SY
authors.lastname: Chung
authors.forename: Chi-Di
authors.initials: CD
authors.lastname: Liang
authors.forename: Hsuan-Chang
authors.initials: HC
authors.lastname: Kuo
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Huang
authors.forename: Shao-Ju
authors.initials: SJ
authors.lastname: Chien
authors.forename: I-Chun
authors.initials: IC
authors.lastname: Lin
authors.forename: Steve
authors.initials: S
authors.lastname: Leu
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: Sheung-Fat
authors.initials: SF
authors.lastname: Ko
authors.forename: Jiunn-Jye
authors.initials: JJ
authors.lastname: Sheu
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D005260:Female; D006548:Hernia, Diaphragmatic / Q000628:therapy; D065630:Hernias, Diaphragmatic, Congenital; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D009205:Myocarditis / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000628:therapy*; D012770:Shock, Cardiogenic / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome