Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality
Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is different from that in adults. The objective of this study was to evaluate the outcomes of E-CPR in infants. Methods: A...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Korean Society for Thoracic & Cardiovascular Surgery
2023-05-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| Summary: | Background: Extracorporeal cardiopulmonary resuscitation (E-CPR) plays an indispensable
role when resuscitation fails; however, extracorporeal life support (ECLS) in infants is
different from that in adults. The objective of this study was to evaluate the outcomes of
E-CPR in infants.
Methods: A single-center retrospective study was conducted, analyzing 51 consecutive
patients (age <1 year) who received E-CPR for in-hospital cardiac arrest between 2010 and
2021.
Results: The median age and body weight was 51 days (interquartile range [IQR], 17–111
days) and 3.4 kg (IQR, 2.9–5.1 kg), respectively. The cause of arrest was cardiogenic in 45
patients (88.2%), and 48 patients (94.1%) had congenital cardiac anomalies. The median
conventional cardiopulmonary resuscitation (C-CPR) time before the initiation of ECLS
was 77 minutes (IQR, 61–103 minutes) and duration of ECLS was 7 days (IQR, 3–12 days).
There were 36 in-hospital deaths (70.6%), and another patient survived after heart transplantation.
In the multivariate analysis, single-ventricular physiology (odds ratio [OR], 5.05;
p=0.048), open sternum status (OR, 8.69; p=0.013), and C-CPR time (OR, 1.47 per 10 minutes;
p=0.021) were significant predictors of in-hospital mortality. In a receiver operating
characteristic curve, the optimal cut-off of C-CPR time was 70.5 minutes. The subgroup
with early E-CPR (C-CPR time <70.5 minutes) showed a tendency for lower in-hospital mortality
tendency (54.5% vs. 82.8%, p=0.060), albeit not statistically significant.
Conclusion: If resuscitation fails in an infant, E-CPR could be a life-saving option. It is
crucial to improve C-CPR quality and shorten the time before ECLS initiation. |
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| ISSN: | 2765-1606 2765-1614 |