Ahmed F ElMahrouk1,2, Mohamed Fouad Ismail2,3, Tamer Hamouda2,4, Rafik Shaikh5, Alaa Mahmoud1,2, Mohammad Sabry Shihata2, Osman Alradi2,6, Ahmed Jamjoom2. 1. Department of Cardiothoracic Surgery, Tanta University Faculty of Medicine, Tanta, Egypt. 2. Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia. 3. Department of Cardiothoracic Surgery, Mansoura University Faculty of Medicine, Mansoura, Egypt. 4. Department of Cardiothoracic Surgery, Benha University Faculty of Medicine, Benha, Egypt. 5. Department of Cardiothoracic Surgery, Perfusion Services, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia. 6. Department of Surgery, King Abdulaziz University, Faculty of Medicine, Jeddah, Saudi Arabia.
Abstract
BACKGROUND: The increasing complexity of congenital cardiac surgery has resulted in the increased use of extracorporeal membrane oxygenation (ECMO) support for children who cannot be weaned from cardiopulmonary bypass. The purpose of this research was to assess the mortality and morbidity in children requiring ECMO support after the repair of congenital heart defects (CHDs). METHODS: The hospital records of all patients with CHD who required ECMO after a cardiac surgical procedure between January 2001 and December 2016 were retrospectively reviewed. Various outcomes were reported and tested for any association with hospital death. RESULTS: A total of 113 children required ECMO for cardiopulmonary support after congenital cardiac surgery; 88 (77.9%) were placed on ECMO in the operating room. Median age of the patients was 3 months (range, 4 days-15 years) and median weight was 3.5 kg (range, 2.2-42.5). Forty-two (37.2%) survived to hospital discharge. In children with single-ventricle physiology, survival to discharge was 37.3% (19/51 patients) and for biventricular physiology, it was 37.1% (23/62 patients). Univariate analysis revealed number of days on ECMO support, renal failure, and stroke as risk factors for hospital mortality, while age and cross-clamp time were found to be statistically nonsignificant. CONCLUSION: Satisfactory results can be achieved in pediatric patients by using ECMO support for postoperative cardiac and pulmonary failure refractory to medical management. Prolonged ECMO support, renal failure, and stroke are risk of mortality. Georg Thieme Verlag KG Stuttgart · New York.
BACKGROUND: The increasing complexity of congenital cardiac surgery has resulted in the increased use of extracorporeal membrane oxygenation (ECMO) support for children who cannot be weaned from cardiopulmonary bypass. The purpose of this research was to assess the mortality and morbidity in children requiring ECMO support after the repair of congenital heart defects (CHDs). METHODS: The hospital records of all patients with CHD who required ECMO after a cardiac surgical procedure between January 2001 and December 2016 were retrospectively reviewed. Various outcomes were reported and tested for any association with hospital death. RESULTS: A total of 113 children required ECMO for cardiopulmonary support after congenital cardiac surgery; 88 (77.9%) were placed on ECMO in the operating room. Median age of the patients was 3 months (range, 4 days-15 years) and median weight was 3.5 kg (range, 2.2-42.5). Forty-two (37.2%) survived to hospital discharge. In children with single-ventricle physiology, survival to discharge was 37.3% (19/51 patients) and for biventricular physiology, it was 37.1% (23/62 patients). Univariate analysis revealed number of days on ECMO support, renal failure, and stroke as risk factors for hospital mortality, while age and cross-clamp time were found to be statistically nonsignificant. CONCLUSION: Satisfactory results can be achieved in pediatric patients by using ECMO support for postoperative cardiac and pulmonary failure refractory to medical management. Prolonged ECMO support, renal failure, and stroke are risk of mortality. Georg Thieme Verlag KG Stuttgart · New York.
Authors: Francesca Sperotto; Paola Cogo; Angela Amigoni; Andrea Pettenazzo; Ravi R Thiagarajan; Angelo Polito Journal: Crit Care Explor Date: 2020-09-15
Authors: Rawan M Alamri; Ahmed M Dohain; Amr A Arafat; Ahmed F Elmahrouk; Abdullah H Ghunaim; Ahmed A Elassal; Ahmed A Jamjoom; Osman O Al-Radi Journal: J Cardiothorac Surg Date: 2020-05-11 Impact factor: 1.637