Skip to main content
SpringerLink
Log in

Early clinical outcomes of new pediatric extracorporeal life support system (Endumo® 2000) in neonates and infants

  • Original Article
  • Published:
Journal of Artificial Organs Aims and scope Submit manuscript

Abstract

We investigated early clinical outcomes of a new extracorporeal life support (ECLS) system (Endumo® 2000, Heiwa Bussan, Tokyo, Japan), which consists of a ROTAFLOW centrifugal pump, a BIOCUBE oxygenator with plasma-leakage-tight polymer fibers, and a biocompatible coating (T-NCVC® coating), in pediatric patients <1 year old. From 2008 to 2011, 31 patients required ECLS. Except for 1 patient who was instituted with a transitional ECLS device, a conventional ECLS system (pediatric Emersave®, TERUMO, Saitama, Japan) was initiated in 14 patients before December 2009 (6 boys, 63.4 ± 87.1 days old, 3.1 ± 1.0 kg), and the Endumo® 2000 was initiated in 16 patients after December 2009 (8 boys, 43.9 ± 78.5 days old, 3.2 ± 0.7 kg). Primary reasons for the institution of ECLS were intraoperative low output syndrome in 11 patients, post-cardiotomy cardiopulmonary collapse in 9 patients, and other reasons in 10 patients. The median support period was 21.7 ± 20.7 days and the total number of circuit exchanges was 83. The median first circuit durability was significantly longer in the Endumo group [8.0 days (range 5.9–13.2) vs. 4.4 days (1.9–8.3)] (p = 0.020). Significant cranial hemorrhage occurred in only 1 patient, who received the Emersave system. The success rate for weaning from ECLS was 14.3 % in the Emersave group and 56.3 % in the Endumo group. Univariate analysis showed that usage of the Endumo® 2000 was a predictor for successful weaning from the ECLS (p = 0.017) as well as survival at discharge (p = 0.032). The Endumo® 2000 system provided safe and effective cardiopulmonary support without complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. del Nido PJ. Extracorporeal membrane oxygenation for cardiac support in children. Ann Thorac Surg. 1996;61:336–9.

    Article  PubMed  Google Scholar 

  2. Duncan BW, Ibrahim AE, Hraska V, del Nido PJ, Laussen PC, Wessel DL, Mayer JE Jr, Bower LK, Jonas RA. Use of rapid-deployment extracorporeal membrane oxygenation for the resuscitation of pediatric patients with heart disease after cardiac arrest. J Thorac Cardiovasc Surg. 1998;116:305–11.

    Article  PubMed  CAS  Google Scholar 

  3. Aharon AS, Drinkwater DC Jr, Churchwell KB, Quisling SV, Reddy VS, Taylor M, Hix S, Christian KG, Pietsch JB, Deshpande JK, Kambam J, Graham TP, Chang PA. Extracorporeal membrane oxygenation in children after repair of congenital cardiac lesions. Ann Thorac Surg. 2001;72:2095–101.

    Article  PubMed  CAS  Google Scholar 

  4. Kolovos NS, Bratton SL, Moler FW, Bove EL, Ohye RG, Bartlett RH, Kulik TJ. Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery. Ann Thorac Surg. 2003;76:1435–41.

    Article  PubMed  Google Scholar 

  5. Hoskote A, Bohn D, Gruenwald C, Edgell D, Cai S, Adatia I, Van Arsdell G. Extracorporeal life support after staged palliation of a functional single ventricle: subsequent morbidity and survival. J Thorac Cardiovasc Surg. 2006;131:1114–21.

    Article  PubMed  Google Scholar 

  6. Thourani VH, Kirshbom PM, Kanter KR, Simsic J, Kogon BE, Wagoner S, Dykes F, Fortenberry J, Forbess JM. Venoarterial extracorporeal membrane oxygenation (VA-ECMO) in pediatric cardiac support. Ann Thorac Surg. 2006;82:138–44.

    Article  PubMed  Google Scholar 

  7. Cooper DS, Jacobs JP, Moore L, Stock A, Gaynor JW, Chancy T, Parpard M, Griffin DA, Owens T, Checchia PA, Thiagarajan RR, Spray TL, Ravishankar C. Cardiac extracorporeal life support: state of the art in 2007. Cardiol Young. 2007;17(Suppl 2):104–15.

    PubMed  Google Scholar 

  8. Alsoufi B, Al-Radi OO, Nazer RI, Gruenwald C, Foreman C, Williams WG, Coles JG, Caldarone CA, Bohn DG, Van Arsdell GS. Survival outcomes after rescue extracorporeal cardiopulmonary resuscitation in pediatric patients with refractory cardiac arrest. J Thorac Cardiovasc Surg. 2007;134:952–9.

    Article  PubMed  Google Scholar 

  9. Chan T, Thiagarajan RR, Frank D, Bratton SL. Survival after extracorporeal cardiopulmonary resuscitation in infants and children with heart disease. J Thorac Cardiovasc Surg. 2008;136:984–92.

    Article  PubMed  Google Scholar 

  10. Alsoufi B, Al-Radi OO, Gruenwald C, Lean L, Williams WG, McCrindle BW, Caldarone CA, Van Arsdell GS. Extra-corporeal life support following cardiac surgery in children: analysis of risk factors and survival in a single institution. Eur J Cardiothorac Surg. 2009;35:1004–11.

    Article  PubMed  Google Scholar 

  11. Delmo Walter EM, Alexi-Meskishvili V, Huebler M, Loforte A, Stiller B, Weng Y, Berger F, Hetzer R. Extracorporeal membrane oxygenation for intraoperative cardiac support in children with congenital heart disease. Interact Cardiovasc Thorac Surg. 2010;10:753–8.

    Article  PubMed  Google Scholar 

  12. Copeland H, Nolan PE, Covington D, Gustafson M, Smith R, Copeland JG. A method for anticoagulation of children on mechanical circulatory support. Artif Organs. 2011;35:1018–23.

    Article  PubMed  Google Scholar 

  13. Mazzucotelli JP, Leprince P, Litzler PY, Vincentelli A, Le Guyader A, Kirsch M, Camilleri L, Flecher E, Reflection Group on Mechanical Circulatory Support (GRAM). Results of mechanical circulatory support in France. Eur J Cardiothorac Surg. 2011;40:e112–7.

    Google Scholar 

  14. McMullan DM, Emmert JA, Permut LC, Mazor RL, Jeffries HE, Parrish AR, Baden HP, Cohen GA. Minimizing bleeding associated with mechanical circulatory support following pediatric heart surgery. Eur J Cardiothorac Surg. 2011;39:392–7.

    Article  PubMed  Google Scholar 

  15. Ueno T, Fukushima N, Sakaguchi T, Ide H, Ozawa H, Saito S, Ichikawa H, Sawa Y. First pediatric heart transplantation from a pediatric donor heart in Japan. Circ J. 2012;76:752–4.

    Article  PubMed  CAS  Google Scholar 

  16. Sato M, Kashiwabara S, Tanaka H, Tatsumi E, Taenaka Y, Takano H. In vitro antithrombogenic evaluation of newly developed heparinized coating material. Jpn Artif Organs. 1999;28:502–8.

    Google Scholar 

  17. Nishinaka T, Tatsumi E, Katagiri N, Ohnishi H, Mizuno T, Shioya K, Tsukiya T, Homma A, Kashiwabara S, Tanaka H, Sato M, Taenaka Y. Up to 151 days of continuous animal perfusion with trivial heparin infusion by the application of a long-term durable antithrombogenic coating to a combination of a seal-less centrifugal pump and a diffusion membrane oxygenator. J Artif Organs. 2007;10:240–4.

    Article  PubMed  CAS  Google Scholar 

  18. Tatsumi E, Taenaka Y, Nakatani T, Akagi H, Sekii H, Yagura A, Sasaki E, Goto M, Nakamura H, Takano H. A VAD and novel high performance compact oxygenator for long-term ECMO with local anticoagulation. ASAIO Trans. 1990;36:M480–3.

    PubMed  CAS  Google Scholar 

  19. Nishinaka T, Tatsumi E, Taenaka Y, Katagiri N, Ohnishi H, Shioya K, Fukuda T, Oshikawa M, Sato K, Tsukiya T, Homma A, Takewa Y, Takano H, Sato M, Kashiwabara S, Tanaka H, Sakai K, Matsuda T. At least thirty-four days of animal continuous perfusion by a newly developed extracorporeal membrane oxygenation system without systemic anticoagulants. Artif Organs. 2002;26:548–51.

    Article  PubMed  CAS  Google Scholar 

  20. Mender N, Podechtl F, Feil G, Hiltmann P, Sebending F. Seal-less centrifugal blood pump with magnetically suspended rotor: Rot-a-Flot. Artif Organs. 1995;19:620–4.

    Article  Google Scholar 

Download references

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka, 565-8565, Japan

    Takaya Hoashi, Koji Kagisaki, Kizuku Yamashita & Hajime Ichikawa

  2. Department of Clinical Engineering, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Takayuki Nishigaki, Kotaro Yoshida & Teruyuki Hayashi

  3. Research Institute, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan

    Eisuke Tatsumi

Authors
  1. Takaya Hoashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Koji Kagisaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kizuku Yamashita
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Eisuke Tatsumi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takayuki Nishigaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Kotaro Yoshida
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Teruyuki Hayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hajime Ichikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Takaya Hoashi or Hajime Ichikawa.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hoashi, T., Kagisaki, K., Yamashita, K. et al. Early clinical outcomes of new pediatric extracorporeal life support system (Endumo® 2000) in neonates and infants. J Artif Organs 16, 267–272 (2013). https://doi.org/10.1007/s10047-013-0713-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10047-013-0713-5

Keywords

Search

Navigation