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Intensive Care Medicine

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01-05-2011 | Pediatric Original

Duration of resuscitation prior to rescue extracorporeal membrane oxygenation impacts outcome in children with heart disease

Authors: V. Ben Sivarajan, Derek Best, Christian P. Brizard, Lara S. Shekerdemian, Yves d’Udekem, Warwick Butt

Published in: Intensive Care Medicine | Issue 5/2011

Abstract

Purpose

Survival outcomes in children with heart disease after use of either non-emergent extracorporeal membrane oxygenation (ECMO) or cardiopulmonary resuscitation (CPR) onto ECMO (ECPR) are comparable. Concerns remain regarding the impact of CPR duration on survival and neurological outcome.

Methods

Children with cardiac disease requiring ECMO were identified from our database. Demographic, operative and ECMO details were evaluated with respect to survival. In addition, resuscitation details were extracted for the recent subgroup requiring ECPR; these details were evaluated with respect to survival and neurological outcomes at midterm follow-up by univariate analysis and multivariable logistic regression.

Results

There were 126 ECMO runs in 116 children; 61 (53%) received ECPR. Forty-eight (41%) children survived to discharge; survival in the most recent era was 48%. Thirty-seven children underwent ECPR in the most recent era with 14 (38%) surviving to discharge. Duration of cardiopulmonary resuscitation differed significantly between survivors and nonsurvivors (15 vs. 40 min, p = 0.009); children requiring ≥30 min of CPR had 79% reduced odds of hospital survival (OR = 0.21, 95% CI = 0.05–0.96, p = 0.04). Two children died after hospital discharge; with 33% having paediatric cerebral performance category scores ≤2. Poor neurological outcome was associated with longer duration of CPR (32 vs. 17.5 min, p = 0.03).

Conclusions

Despite comparable survival outcomes between ECPR and non-emergent ECMO in children with cardiac disease a significant association between CPR duration and outcome (survival and neurological) was noted in this population.

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Title: Duration of resuscitation prior to rescue extracorporeal membrane oxygenation impacts outcome in children with heart disease
Authors: V. Ben Sivarajan
Derek Best
Christian P. Brizard
Lara S. Shekerdemian
Yves d’Udekem
Warwick Butt
Publication date: 01-05-2011
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 5/2011
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-011-2168-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Duration of resuscitation prior to rescue extracorporeal membrane oxygenation impacts outcome in children with heart disease

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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