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01-06-2019 | Myocarditis | Original Article

Outcomes following venoarterial extracorporeal membrane oxygenation in children with refractory cardiogenic disease

Authors: Lijun Yang, Lifen Ye, Yong Fan, Wenlong He, Qing Zong, Wenting Zhao, Ru Lin

Published in: European Journal of Pediatrics | Issue 6/2019

Abstract

Retrospective analysis was performed at an affiliated university children’s hospital with consecutive patients receiving a venoarterial extracorporeal membrane oxygenation (VA-ECMO) for refractory cardiogenic shock from July 2007 to May 2018. Fifty-six patients underwent VA-ECMO for refractory cardiogenic shock with the median age of 39.0 (1.5, 103.5) months were included. Median ECMO duration was 87 h, and the median length of hospital stay was 22 days. Successful ECMO weaning rate was 68%. Thirty-day mortality in this cohort was 39% (22/56), among which the mortality of fulminant myocarditis and postcardiotomy cardiogenic shock (PCS) were 23% (6/26) and 52% (12/23), respectively. Multivariate Cox proportional hazard regression analysis identified prolonged prothrombin time (PT) > 6 s and elevated lactate level 24 h after ECMO initiation were associated with 30-day mortality.

Conclusions: Pediatric VA-ECMO for refractory cardiogenic shock appears to be a satisfactory salvage therapy to various fatal diseases in this retrospective study. Prolonged PT > 6 s and elevated lactate level 24 h were significant predictors of 30-day mortality.

What is Known: • VA-ECMO is a salvage therapy for refractory cardiogenic shock in pediatrics.
What is New: • Prothrombin time > 6 s was a significant predictor of 30-day mortality. • Elevated lactate level 24 h was a significant predictor of 30-day mortality

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Title: Outcomes following venoarterial extracorporeal membrane oxygenation in children with refractory cardiogenic disease
Authors: Lijun Yang
Lifen Ye
Yong Fan
Wenlong He
Qing Zong
Wenting Zhao
Ru Lin
Publication date: 01-06-2019
Publisher: Springer Berlin Heidelberg
Keywords: Myocarditis
Cardiogenic Shock
Cardiogenic Shock
ECMO
ECMO
Published in: European Journal of Pediatrics / Issue 6/2019
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-019-03352-5

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Outcomes following venoarterial extracorporeal membrane oxygenation in children with refractory cardiogenic disease

Abstract

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