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Pediatric extracorporeal cardiopulmonary resuscitation: single-center study
BACKGROUND/AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to eva...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Scientific and Technological Research Council of Turkey
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569742/ https://www.ncbi.nlm.nih.gov/pubmed/33350296 http://dx.doi.org/10.3906/sag-2002-10 |
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author | KENDİRLİ, Tanıl ÖZCAN, Serhan HAVAN, Merve BARAN, Cağdaş ÇAKICI, Mehmet ARICI, Burcu SELVİ CAN, Özlem EYİLETEN, Zeynep UÇAR, Tayfun TUTAR, Ercan AKAR, Ahmet Rüçhan |
author_facet | KENDİRLİ, Tanıl ÖZCAN, Serhan HAVAN, Merve BARAN, Cağdaş ÇAKICI, Mehmet ARICI, Burcu SELVİ CAN, Özlem EYİLETEN, Zeynep UÇAR, Tayfun TUTAR, Ercan AKAR, Ahmet Rüçhan |
author_sort | KENDİRLİ, Tanıl |
collection | PubMed |
description | BACKGROUND/AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to evaluate the clinical outcomes of our ECPR experience in a pediatric patient population. MATERIALS AND METHODS: Between September 2014 and November 2017, 15 children were supported with ECPR following in-hospital cardiac arrest (IHCA) in our hospitals. VA-ECMO setting was established for all patients. Pediatric cerebral performance category (PCPC) scales and long-term neurological prognosis of the survivors were assessed. RESULTS: The median age of the study population was 60 (4–156) months. The median weight was 18 (4.8–145) kg, height was 115 (63–172) cm, and body surface area was 0.73 (0.27–2.49) m(2). The cause of cardiac arrest was a cardiac and circulatory failure in 12 patients (80%) and noncardiac causes in 20%. Dysrhythmia was present in 46%, septic shock in 13%, bleeding in 6%, low cardiac output syndrome in 13%, and airway disease in 6% of the study population. Median low-flow time was 95 (range 20–320) min. Central VA-ECMO cannulation was placed in only 2 (13.3%) cases. However, the return of spontaneous circulation (ROSC) was obtained in 10 (66.6%) patients, and 5 (50%) of them survived. Overall, 5 patients were discharged from the hospital. Finally, survival following ECPR was 33.3%, and all survivors were neurologically intact at hospital-discharge. CONCLUSION: ECPR can be a life-saving therapeutic strategy using a promising technology in the pediatric IHCA population. Early initiation and a well-coordinated, skilled, and dedicated ECMO team are the mainstay for better survival rates. |
format | Online Article Text |
id | pubmed-8569742 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Scientific and Technological Research Council of Turkey |
record_format | MEDLINE/PubMed |
spelling | pubmed-85697422021-11-17 Pediatric extracorporeal cardiopulmonary resuscitation: single-center study KENDİRLİ, Tanıl ÖZCAN, Serhan HAVAN, Merve BARAN, Cağdaş ÇAKICI, Mehmet ARICI, Burcu SELVİ CAN, Özlem EYİLETEN, Zeynep UÇAR, Tayfun TUTAR, Ercan AKAR, Ahmet Rüçhan Turk J Med Sci Article BACKGROUND/AIM: Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to evaluate the clinical outcomes of our ECPR experience in a pediatric patient population. MATERIALS AND METHODS: Between September 2014 and November 2017, 15 children were supported with ECPR following in-hospital cardiac arrest (IHCA) in our hospitals. VA-ECMO setting was established for all patients. Pediatric cerebral performance category (PCPC) scales and long-term neurological prognosis of the survivors were assessed. RESULTS: The median age of the study population was 60 (4–156) months. The median weight was 18 (4.8–145) kg, height was 115 (63–172) cm, and body surface area was 0.73 (0.27–2.49) m(2). The cause of cardiac arrest was a cardiac and circulatory failure in 12 patients (80%) and noncardiac causes in 20%. Dysrhythmia was present in 46%, septic shock in 13%, bleeding in 6%, low cardiac output syndrome in 13%, and airway disease in 6% of the study population. Median low-flow time was 95 (range 20–320) min. Central VA-ECMO cannulation was placed in only 2 (13.3%) cases. However, the return of spontaneous circulation (ROSC) was obtained in 10 (66.6%) patients, and 5 (50%) of them survived. Overall, 5 patients were discharged from the hospital. Finally, survival following ECPR was 33.3%, and all survivors were neurologically intact at hospital-discharge. CONCLUSION: ECPR can be a life-saving therapeutic strategy using a promising technology in the pediatric IHCA population. Early initiation and a well-coordinated, skilled, and dedicated ECMO team are the mainstay for better survival rates. The Scientific and Technological Research Council of Turkey 2021-08-30 /pmc/articles/PMC8569742/ /pubmed/33350296 http://dx.doi.org/10.3906/sag-2002-10 Text en Copyright © 2021 The Author(s) https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ), which permits unrestricted use and redistribution provided that the original author and source are credited. |
spellingShingle | Article KENDİRLİ, Tanıl ÖZCAN, Serhan HAVAN, Merve BARAN, Cağdaş ÇAKICI, Mehmet ARICI, Burcu SELVİ CAN, Özlem EYİLETEN, Zeynep UÇAR, Tayfun TUTAR, Ercan AKAR, Ahmet Rüçhan Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title | Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title_full | Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title_fullStr | Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title_full_unstemmed | Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title_short | Pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
title_sort | pediatric extracorporeal cardiopulmonary resuscitation: single-center study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8569742/ https://www.ncbi.nlm.nih.gov/pubmed/33350296 http://dx.doi.org/10.3906/sag-2002-10 |
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