Cargando…

Extracorporeal life support in pediatric cardiac dysfunction

BACKGROUND: Low cardiac output (LCO) after corrective surgery remains a serious complication in pediatric congenital heart diseases (CHD). In the case of refractory LCO, extra corporeal life support (ECLS) extra corporeal membrane oxygenation (ECMO) or ventricle assist devices (VAD) is the final the...

Descripción completa

Detalles Bibliográficos
Autores principales: Coskun, Kasim O, Coskun, Sinan T, Popov, Aron F, Hinz, Jose, El-Arousy, Mahmoud, Schmitto, Jan D, Kececioglu, Deniz, Koerfer, Reiner
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993705/
https://www.ncbi.nlm.nih.gov/pubmed/21083896
http://dx.doi.org/10.1186/1749-8090-5-112
_version_ 1782192833482981376
author Coskun, Kasim O
Coskun, Sinan T
Popov, Aron F
Hinz, Jose
El-Arousy, Mahmoud
Schmitto, Jan D
Kececioglu, Deniz
Koerfer, Reiner
author_facet Coskun, Kasim O
Coskun, Sinan T
Popov, Aron F
Hinz, Jose
El-Arousy, Mahmoud
Schmitto, Jan D
Kececioglu, Deniz
Koerfer, Reiner
author_sort Coskun, Kasim O
collection PubMed
description BACKGROUND: Low cardiac output (LCO) after corrective surgery remains a serious complication in pediatric congenital heart diseases (CHD). In the case of refractory LCO, extra corporeal life support (ECLS) extra corporeal membrane oxygenation (ECMO) or ventricle assist devices (VAD) is the final therapeutic option. In the present study we have reviewed the outcomes of pediatric patients after corrective surgery necessitating ECLS and compared outcomes with pediatric patients necessitating ECLS because of dilatated cardiomyopathy (DCM). METHODS: A retrospective single-centre cohort study was evaluated in pediatric patients, between 1991 and 2008, that required ECLS. A total of 48 patients received ECLS, of which 23 were male and 25 female. The indications for ECLS included CHD in 32 patients and DCM in 16 patients. RESULTS: The mean age was 1.2 ± 3.9 years for CHD patients and 10.4 ± 5.8 years for DCM patients. Twenty-six patients received ECMO and 22 patients received VAD. A total of 15 patients out of 48 survived, 8 were discharged after myocardial recovery and 7 were discharged after successful heart transplantation. The overall mortality in patients with extracorporeal life support was 68%. CONCLUSION: Although the use of ECLS shows a significantly high mortality rate it remains the ultimate chance for children. For better results, ECLS should be initiated in the operating room or shortly thereafter. Bridge to heart transplantation should be considered if there is no improvement in cardiac function to avoid irreversible multiorgan failure (MFO).
format Text
id pubmed-2993705
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-29937052010-11-30 Extracorporeal life support in pediatric cardiac dysfunction Coskun, Kasim O Coskun, Sinan T Popov, Aron F Hinz, Jose El-Arousy, Mahmoud Schmitto, Jan D Kececioglu, Deniz Koerfer, Reiner J Cardiothorac Surg Research Article BACKGROUND: Low cardiac output (LCO) after corrective surgery remains a serious complication in pediatric congenital heart diseases (CHD). In the case of refractory LCO, extra corporeal life support (ECLS) extra corporeal membrane oxygenation (ECMO) or ventricle assist devices (VAD) is the final therapeutic option. In the present study we have reviewed the outcomes of pediatric patients after corrective surgery necessitating ECLS and compared outcomes with pediatric patients necessitating ECLS because of dilatated cardiomyopathy (DCM). METHODS: A retrospective single-centre cohort study was evaluated in pediatric patients, between 1991 and 2008, that required ECLS. A total of 48 patients received ECLS, of which 23 were male and 25 female. The indications for ECLS included CHD in 32 patients and DCM in 16 patients. RESULTS: The mean age was 1.2 ± 3.9 years for CHD patients and 10.4 ± 5.8 years for DCM patients. Twenty-six patients received ECMO and 22 patients received VAD. A total of 15 patients out of 48 survived, 8 were discharged after myocardial recovery and 7 were discharged after successful heart transplantation. The overall mortality in patients with extracorporeal life support was 68%. CONCLUSION: Although the use of ECLS shows a significantly high mortality rate it remains the ultimate chance for children. For better results, ECLS should be initiated in the operating room or shortly thereafter. Bridge to heart transplantation should be considered if there is no improvement in cardiac function to avoid irreversible multiorgan failure (MFO). BioMed Central 2010-11-17 /pmc/articles/PMC2993705/ /pubmed/21083896 http://dx.doi.org/10.1186/1749-8090-5-112 Text en Copyright © 2010 Coskun et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Coskun, Kasim O
Coskun, Sinan T
Popov, Aron F
Hinz, Jose
El-Arousy, Mahmoud
Schmitto, Jan D
Kececioglu, Deniz
Koerfer, Reiner
Extracorporeal life support in pediatric cardiac dysfunction
title Extracorporeal life support in pediatric cardiac dysfunction
title_full Extracorporeal life support in pediatric cardiac dysfunction
title_fullStr Extracorporeal life support in pediatric cardiac dysfunction
title_full_unstemmed Extracorporeal life support in pediatric cardiac dysfunction
title_short Extracorporeal life support in pediatric cardiac dysfunction
title_sort extracorporeal life support in pediatric cardiac dysfunction
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993705/
https://www.ncbi.nlm.nih.gov/pubmed/21083896
http://dx.doi.org/10.1186/1749-8090-5-112
work_keys_str_mv AT coskunkasimo extracorporeallifesupportinpediatriccardiacdysfunction
AT coskunsinant extracorporeallifesupportinpediatriccardiacdysfunction
AT popovaronf extracorporeallifesupportinpediatriccardiacdysfunction
AT hinzjose extracorporeallifesupportinpediatriccardiacdysfunction
AT elarousymahmoud extracorporeallifesupportinpediatriccardiacdysfunction
AT schmittojand extracorporeallifesupportinpediatriccardiacdysfunction
AT kececiogludeniz extracorporeallifesupportinpediatriccardiacdysfunction
AT koerferreiner extracorporeallifesupportinpediatriccardiacdysfunction