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Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates

Background  Extracorporeal membrane oxygenation (ECMO) provides circulatory support in children with congenital heart disease, particularly in the setting of cardiopulmonary failure and inability to wean from cardiopulmonary bypass. This study summarized the clinical application of ECMO in the treat...

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Autores principales: Yu, Xindi, Yang, Yinyu, Zhang, Wei, Guo, Zheng, Shen, Jia, Xu, Zhuoming, Zhang, Haibo, Wang, Wei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Georg Thieme Verlag KG 2021
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324001/
https://www.ncbi.nlm.nih.gov/pubmed/34327689
http://dx.doi.org/10.1055/s-0041-1730034
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author Yu, Xindi
Yang, Yinyu
Zhang, Wei
Guo, Zheng
Shen, Jia
Xu, Zhuoming
Zhang, Haibo
Wang, Wei
author_facet Yu, Xindi
Yang, Yinyu
Zhang, Wei
Guo, Zheng
Shen, Jia
Xu, Zhuoming
Zhang, Haibo
Wang, Wei
author_sort Yu, Xindi
collection PubMed
description Background  Extracorporeal membrane oxygenation (ECMO) provides circulatory support in children with congenital heart disease, particularly in the setting of cardiopulmonary failure and inability to wean from cardiopulmonary bypass. This study summarized the clinical application of ECMO in the treatment of heart failure after cardiac surgery in neonates. Materials and Methods  Clinical data of 23 neonates who received ECMO support in our center from January 2017 to June 2019 were retrospectively analyzed. Results  Twenty-three neonates, aged from 0 to 25 days and weight between 2,300 and 4,500 g, with heart failure postcardiotomy were supported with ECMO. The successful weaning rate was 78.26% and discharge rate was 52.17%. Bleeding and residual malformation were the most common complications. The univariate analysis showed that nonsurvivors were related to the factors such as higher lactate value of ECMO 12 and 24 hours ( p  = 0.008 and 0.001, respectively), longer time to lactate normalization ( p  = 0.001), lactate > 10 mmol/L before ECMO ( p  = 0.01), lower weight ( p  = 0.01), longer ECMO duration ( p  = 0.005), lower platelet count ( p  = 0.001), more surgical site bleeding ( p  = 0.001), and surgical residual malformation ( p  = 0.04). Further logistic regression analysis revealed that higher lactate value of ECMO 24 hours ( p  = 0.003), longer ECMO duration ( p  = 0.015), and surgical site bleeding ( p  = 0.025) were independent risk factors. Conclusion  ECMO was an effective technology to support the neonates with cardiopulmonary failure after open heart surgery. Control the lactate acidosis and surgical site bleeding event may be helpful for patients' recovery.
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spelling pubmed-83240012021-08-09 Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates Yu, Xindi Yang, Yinyu Zhang, Wei Guo, Zheng Shen, Jia Xu, Zhuoming Zhang, Haibo Wang, Wei Thorac Cardiovasc Surg Background  Extracorporeal membrane oxygenation (ECMO) provides circulatory support in children with congenital heart disease, particularly in the setting of cardiopulmonary failure and inability to wean from cardiopulmonary bypass. This study summarized the clinical application of ECMO in the treatment of heart failure after cardiac surgery in neonates. Materials and Methods  Clinical data of 23 neonates who received ECMO support in our center from January 2017 to June 2019 were retrospectively analyzed. Results  Twenty-three neonates, aged from 0 to 25 days and weight between 2,300 and 4,500 g, with heart failure postcardiotomy were supported with ECMO. The successful weaning rate was 78.26% and discharge rate was 52.17%. Bleeding and residual malformation were the most common complications. The univariate analysis showed that nonsurvivors were related to the factors such as higher lactate value of ECMO 12 and 24 hours ( p  = 0.008 and 0.001, respectively), longer time to lactate normalization ( p  = 0.001), lactate > 10 mmol/L before ECMO ( p  = 0.01), lower weight ( p  = 0.01), longer ECMO duration ( p  = 0.005), lower platelet count ( p  = 0.001), more surgical site bleeding ( p  = 0.001), and surgical residual malformation ( p  = 0.04). Further logistic regression analysis revealed that higher lactate value of ECMO 24 hours ( p  = 0.003), longer ECMO duration ( p  = 0.015), and surgical site bleeding ( p  = 0.025) were independent risk factors. Conclusion  ECMO was an effective technology to support the neonates with cardiopulmonary failure after open heart surgery. Control the lactate acidosis and surgical site bleeding event may be helpful for patients' recovery. Georg Thieme Verlag KG 2021-12 2021-07-29 /pmc/articles/PMC8324001/ /pubmed/34327689 http://dx.doi.org/10.1055/s-0041-1730034 Text en The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits unrestricted reproduction and distribution, for non-commercial purposes only; and use and reproduction, but not distribution, of adapted material for non-commercial purposes only, provided the original work is properly cited.
spellingShingle Yu, Xindi
Yang, Yinyu
Zhang, Wei
Guo, Zheng
Shen, Jia
Xu, Zhuoming
Zhang, Haibo
Wang, Wei
Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title_full Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title_fullStr Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title_full_unstemmed Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title_short Postcardiotomy Extracorporeal Membrane Oxygenation in Neonates
title_sort postcardiotomy extracorporeal membrane oxygenation in neonates
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8324001/
https://www.ncbi.nlm.nih.gov/pubmed/34327689
http://dx.doi.org/10.1055/s-0041-1730034
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