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Titolo:
Extracorporeal membrane oxygenation in children after repair of congenitalcardiac lesions
Autore:
Aharon, AS; Drinkwater, DC; Churchwell, KB; Quisling, SV; Reddy, VS; Taylor, M; Hix, S; Christian, KG; Pietsch, JB; Deshpande, JK; Kambam, J; Graham, TP; Chang, PA;
Indirizzi:
Vanderbilt Univ, Med Ctr, Vanderbilt Clin 2986, Div Cardiothorac Surg,DeptCardiac & Thorac Surg, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 orac Surg, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Div Cardiothorac Anesthesia, Dept Pediat, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 pt Pediat, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Div Cardiothorac Anesthesia, Dept Anesthesiol, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 esthesiol, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Div Cardiothorac Anesthesia, ECMO Dept, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 ECMO Dept, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Div Cardiothorac Anesthesia, Dept Pediat Surg, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 diat Surg, Nashville, TN 37232 USA Vanderbilt Univ, Med Ctr, Dept Pediat Cardiol, Nashville, TN 37232 USA Vanderbilt Univ Nashville TN USA 37232 t Cardiol, Nashville, TN 37232 USA
Titolo Testata:
ANNALS OF THORACIC SURGERY
fascicolo: 6, volume: 72, anno: 2001,
pagine: 2095 - 2101
SICI:
0003-4975(200112)72:6<2095:EMOICA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
MECHANICAL CIRCULATORY SUPPORT; HEART-TRANSPLANTATION; PEDIATRIC-PATIENTS; LIFE-SUPPORT; DISEASE; RESUSCITATION; BRIDGE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
17
Recensione:
Indirizzi per estratti:
Indirizzo: Drinkwater, DC Vanderbilt Univ, Med Ctr, Vanderbilt Clin 2986, Div Cardiothorac Surg,DeptCardiac & Thorac Surg, 1301 22nd Ave S, Nashville, TN 37232 USA Vanderbilt Univ 1301 22nd Ave S Nashville TN USA 37232 USA
Citazione:
A.S. Aharon et al., "Extracorporeal membrane oxygenation in children after repair of congenitalcardiac lesions", ANN THORAC, 72(6), 2001, pp. 2095-2101

Abstract

Background. The purpose of this study was to review our experience in the early application of extracorporeal membrane oxygenation (ECMO) in patientsrequiring mechanical assistance after cardiac surgical procedures. Methods. The hospital records of all children requiring ECMO after cardiacoperation were retrospectively reviewed, and an analysis of variables affecting survival was performed. Results. Fifty pediatric patients between May 1997 and October 2000 required ECMO for cardiopulmonary support after cardiac operation. Patients ranged in age from 1 day to 11 years (median age, 40 days). Forty-eight patientsunderwent repair of congenital cardiac lesions and 2 were included after receiving a heart transplant. Twenty-two children could not be weaned from cardiopulmonary bypass and were placed on ECMO in the operating room for circulatory support. Of the 28 children who required ECMO in the intensive care unit, 10 had ECMO instituted after cardiopulmonary arrest (mean cardiopulmonary resuscitation time, 42 minutes; range, 5 to 110 minutes). In infantswith single-ventricle physiology, survival to discharge was 61% (11 of 18 patients) as compared with 43% (14 of 32 patients) in those with biventricular physiology. Thirty of the 50 patients (60%) were successfully weaned from ECMO, of which 25 (83%) were discharged home. Overall survival to discharge in the entire cohort was 50%. Extracorporeal membrane oxygenation support greater than 72 hours was a grave prognostic indicator. Overall survivalin this group was 36% (9 of 25 patients) compared with 56% (14 of 25 patients) in those with ECMO support less than 72 hours (p < 0.05). Univariate analysis revealed the presence of renal failure, extended periods of circulatory support, and a prolonged period of cardiopulmonary resuscitation as risk factors for mortality. The presence of shunt-dependent flow, operative procedure, and institution of ECMO in the intensive care unit did not alter survival. Conclusions. Extracorporeal membrane oxygenation provides effective support for postoperative cardiac and pulmonary failure refractory to medical management. Early institution of ECMO may decrease the incidence of cardiac arrest and end-organ damage, thus increasing survival in these critically illpatients. (C) 2001 by The Society of Thoracic Surgeons.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/01/20 alle ore 17:05:37