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...
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| Format: | Article |
| Language: | English |
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Korean Society for Thoracic & Cardiovascular Surgery
2023-05-01
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| Series: | Journal of Chest Surgery |
| Subjects: |
| _version_ | 1797833585691983872 |
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| author | Byeong A Yoo Seungmo Yoo Eun Seok Choi Bo Sang Kwon Chun Soo Park Tae-Jin Yun Dong-Hee Kim |
| author_facet | Byeong A Yoo Seungmo Yoo Eun Seok Choi Bo Sang Kwon Chun Soo Park Tae-Jin Yun Dong-Hee Kim |
| author_sort | Byeong A Yoo |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-09T14:26:27Z |
| format | Article |
| id | doaj.art-bce9e5d059134a62b7d74e6e7f34244f |
| institution | Directory Open Access Journal |
| issn | 2765-1606 2765-1614 |
| language | English |
| last_indexed | 2024-04-09T14:26:27Z |
| publishDate | 2023-05-01 |
| publisher | Korean Society for Thoracic & Cardiovascular Surgery |
| record_format | Article |
| series | Journal of Chest Surgery |
| spelling | doaj.art-bce9e5d059134a62b7d74e6e7f34244f2023-05-04T05:04:31ZengKorean Society for Thoracic & Cardiovascular SurgeryJournal of Chest Surgery2765-16062765-16142023-05-0156316217010.5090/jcs.22.138Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of MortalityByeong A Yoo0https://orcid.org/0000-0002-8158-3513Seungmo Yoo1https://orcid.org/0000-0001-8988-679XEun Seok Choi2https://orcid.org/0000-0002-0618-4686Bo Sang Kwon3https://orcid.org/0000-0002-0365-4339Chun Soo Park4https://orcid.org/0000-0001-8718-8904Tae-Jin Yun5https://orcid.org/0000-0002-0336-1720Dong-Hee Kim6https://orcid.org/0000-0002-4021-8712University of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineUniversity of Ulsan College of MedicineBackground: 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.pediatric cardiopulmonary resuscitationconventional cardiopulmonary resuscitationextracorporeal cardiopulmonary resuscitationpediatric extracorporeal membrane oxygentation |
| spellingShingle | Byeong A Yoo Seungmo Yoo Eun Seok Choi Bo Sang Kwon Chun Soo Park Tae-Jin Yun Dong-Hee Kim Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality Journal of Chest Surgery pediatric cardiopulmonary resuscitation conventional cardiopulmonary resuscitation extracorporeal cardiopulmonary resuscitation pediatric extracorporeal membrane oxygentation |
| title | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality |
| title_full | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality |
| title_fullStr | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality |
| title_full_unstemmed | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality |
| title_short | Extracorporeal Cardiopulmonary Resuscitation in Infants: Outcomes and Predictors of Mortality |
| title_sort | extracorporeal cardiopulmonary resuscitation in infants outcomes and predictors of mortality |
| topic | pediatric cardiopulmonary resuscitation conventional cardiopulmonary resuscitation extracorporeal cardiopulmonary resuscitation pediatric extracorporeal membrane oxygentation |
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