title: Comparative effects of ventricular assist device and extracorporeal membrane oxygenation on renal function in pediatric heart failure.
abstract: BACKGROUND
  Effects of mechanical cardiac support on renal function in children with end-stage heart failure are unknown. The objective of this study was to investigate the impact of ventricular assist device (VAD) and extracorporeal membrane oxygenation (ECMO) on renal function in children.
  
  
  METHODS
  We performed a single center retrospective observational study in children with end-stage heart failure supported on pediatric mechanical cardiac support. The patient population was divided into three groups: the VAD group included patients receiving ventricular assist device support; the ECMO group included patients receiving extracorporeal membrane oxygenation membrane support for more than 14 days; and the ECMO+VAD group included patients receiving ECMO followed by VAD support. Comparison of baseline characteristics, duration of mechanical cardiac support, and renal function was made between the three groups.
  
  
  RESULTS
  During the study period, there were 23 patients in the VAD group, 16 patients in the ECMO+VAD group, and 37 patients in the ECMO group. The patients in the ECMO group were significantly younger and smaller than the patients in the VAD and ECMO+VAD groups. There was a steady improvement in eGFR in the VAD group and the ECMO+VAD group until day 7 after which there was a decline in renal function. In the ECMO group, the improvement in eGFR continued until day 28 after which there was a steady decline in eGFR. Improvement in eGFR in the VAD group and the ECMO+VAD group was much higher than in the ECMO group in the first 7 days.
  
  
  CONCLUSIONS
  On the basis of these data, we demonstrate that renal dysfunction improves early after mechanical cardiac support.
authors.affiliation: Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Pediatric Critical Care, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Parthak
authors.initials: P
authors.lastname: Prodhan
authors.affiliation: Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Pediatric Critical Care, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Adnan T
authors.initials: AT
authors.lastname: Bhutta
authors.affiliation: Section of Biostatistics, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Gossett
authors.affiliation: Section of Medical Education, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Dodgen
authors.affiliation: Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Seib
authors.affiliation: Department of Cardiothoracic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas.
authors.forename: Michiaki
authors.initials: M
authors.lastname: Imamura
authors.affiliation: Division of Pediatric Cardiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas; Division of Pediatric Critical Care, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Electronic address: pgupta2@uams.edu.
authors.forename: Punkaj
authors.initials: P
authors.lastname: Gupta
mesh_terms: D002648:Child; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology* / Q000601:surgery*; D006353:Heart-Assist Devices; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007668:Kidney / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000503:physiopathology*; D008297:Male; D012189:Retrospective Studies
keywords: 27