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DOI: 10.1055/s-2005-862042
Mid-term survival after continuous postoperative cardiac support in pediatric patients with V-A-ECMO
Objectives: Evaluation of ECMO-support in pediatric patients after open heart surgery in the setting of a retrospective single-center study.
Material and Methods: Between 01/2002 and 9/2004 twenty-one of 476 patients (4.4%) required immediate or delayed ECMO-support after open heart surgery for different situations. Settings where patients went on ECMO-support were postoperative low-output-syndrome (n=13; 61.9%), rapidly after post-operative resuscitation (n=3; 14.3%) or because of severely impaired preoperative ventricular function (n=5; 23.8%).
Results: There were 12 (57.1%) early and 3 (14.3%) late deaths. Cause of death was predominantly cardiac (n=13; 86.7%). Two patients died because of severe cerebral bleeding (13.3%). Weaning from ECMO-support was possible in 13 (61.9%) of all our patients. Only 6 (46.2%) of these patients are currently alive and survived in the long-term. Quality of life is good in 5 (83.3%) patients, one patient is handicapped after cerebral hemorrhage occurring one day after ECMO explantation.
Conclusions: ECMO is nowerdays a common used tool for postoperative cardiac support in pediatric patients after open heart surgery. Results have improved, but remain controversial. Success depends on cardiac function, absence of bleeding and type of repair.
Neurologic complications with moderate to severe functional impairment are the most common sequelae, limiting early and long-term successful results significantly.