Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience
Abstract Background Extracorporeal membrane oxygenation (ECMO) has become an integral part of paediatric cardiac surgery. We report the experience of a well-established ECMO service over 5 years. Methods This retrospective study analysed all paediatric patients who required ECMO support following ca...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-11-01
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| Series: | Journal of Cardiothoracic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13019-023-02440-w |
| _version_ | 1797629968636706816 |
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| author | Laurynas Bezuska Jonathan P. O’Doherty Bilal Ali Chris Harvey Ikenna Omeje Branko Mimic |
| author_facet | Laurynas Bezuska Jonathan P. O’Doherty Bilal Ali Chris Harvey Ikenna Omeje Branko Mimic |
| author_sort | Laurynas Bezuska |
| collection | DOAJ |
| description | Abstract Background Extracorporeal membrane oxygenation (ECMO) has become an integral part of paediatric cardiac surgery. We report the experience of a well-established ECMO service over 5 years. Methods This retrospective study analysed all paediatric patients who required ECMO support following cardiac surgery from April 2015 to March 2020. Inclusion criteria were age less than 18 years and post-operative ECMO support. Patients were analysed dividing into groups according to the urgency for ECMO support (extracorporeal cardiopulmonary resuscitation (ECPR) and cardiac ECMO) and according to age (neonatal and paediatric ECMO groups). They were followed for 30-day, 6-month mortality, long-term survival, postoperative morbidity and the need for reintervention. Results Forty-six patients were included who had a total of venoarterial (VA) 8 ECMO runs. The 5-year incidence of the need for VA ECMO after cardiac surgery was 3.3% (48 of the overall 1441 cases recorded). The median follow-up period was 3.5 (interquartile ranges, 0.8–4.7) years. Thirty-day, 6-month and follow-up survival rate was 85%, 65% and 52% respectively. At the 6-month follow-up, the ECPR group showed a trend towards worse survival compared with the cardiac ECMO group (47% vs. 55%) but with no statistical significance (p = 0.35). Furthermore, the survival rates between paediatric (60%) and neonatal (46%) ECMO groups were similar, with no statistical significance (p = 0.45). The rate of acute neurological events was 27% (13/48). Conclusion ECPR and neonatal ECMO groups had higher mortality. VA ECMO 30-day and 6-month survival rates were 85% and 65% respectively. Major neurological injury resulting in ECMO termination occurred in 3 patients. Accumulated experiences and protocols in ECMO management can improve mortality and morbidity. |
| first_indexed | 2024-03-11T11:01:20Z |
| format | Article |
| id | doaj.art-9ae409e8ff6043908b7eb71fcf941e96 |
| institution | Directory Open Access Journal |
| issn | 1749-8090 |
| language | English |
| last_indexed | 2024-03-11T11:01:20Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Cardiothoracic Surgery |
| spelling | doaj.art-9ae409e8ff6043908b7eb71fcf941e962023-11-12T12:29:51ZengBMCJournal of Cardiothoracic Surgery1749-80902023-11-011811810.1186/s13019-023-02440-wExtracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experienceLaurynas Bezuska0Jonathan P. O’Doherty1Bilal Ali2Chris Harvey3Ikenna Omeje4Branko Mimic5East Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustEast Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustEast Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustEast Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustEast Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustEast Midlands Congenital Heart Centre, University Hospitals of Leicester NHS TrustAbstract Background Extracorporeal membrane oxygenation (ECMO) has become an integral part of paediatric cardiac surgery. We report the experience of a well-established ECMO service over 5 years. Methods This retrospective study analysed all paediatric patients who required ECMO support following cardiac surgery from April 2015 to March 2020. Inclusion criteria were age less than 18 years and post-operative ECMO support. Patients were analysed dividing into groups according to the urgency for ECMO support (extracorporeal cardiopulmonary resuscitation (ECPR) and cardiac ECMO) and according to age (neonatal and paediatric ECMO groups). They were followed for 30-day, 6-month mortality, long-term survival, postoperative morbidity and the need for reintervention. Results Forty-six patients were included who had a total of venoarterial (VA) 8 ECMO runs. The 5-year incidence of the need for VA ECMO after cardiac surgery was 3.3% (48 of the overall 1441 cases recorded). The median follow-up period was 3.5 (interquartile ranges, 0.8–4.7) years. Thirty-day, 6-month and follow-up survival rate was 85%, 65% and 52% respectively. At the 6-month follow-up, the ECPR group showed a trend towards worse survival compared with the cardiac ECMO group (47% vs. 55%) but with no statistical significance (p = 0.35). Furthermore, the survival rates between paediatric (60%) and neonatal (46%) ECMO groups were similar, with no statistical significance (p = 0.45). The rate of acute neurological events was 27% (13/48). Conclusion ECPR and neonatal ECMO groups had higher mortality. VA ECMO 30-day and 6-month survival rates were 85% and 65% respectively. Major neurological injury resulting in ECMO termination occurred in 3 patients. Accumulated experiences and protocols in ECMO management can improve mortality and morbidity.https://doi.org/10.1186/s13019-023-02440-wExtracorporeal membrane oxygenationPaediatricCardiac ECMO |
| spellingShingle | Laurynas Bezuska Jonathan P. O’Doherty Bilal Ali Chris Harvey Ikenna Omeje Branko Mimic Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience Journal of Cardiothoracic Surgery Extracorporeal membrane oxygenation Paediatric Cardiac ECMO |
| title | Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience |
| title_full | Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience |
| title_fullStr | Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience |
| title_full_unstemmed | Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience |
| title_short | Extracorporeal membrane oxygenation in paediatric cardiac surgery: 5-year single centre experience |
| title_sort | extracorporeal membrane oxygenation in paediatric cardiac surgery 5 year single centre experience |
| topic | Extracorporeal membrane oxygenation Paediatric Cardiac ECMO |
| url | https://doi.org/10.1186/s13019-023-02440-w |
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