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Results of Extracorporeal Cardiopulmonary Resuscitation in Children

Authors
 Hong Ju Shin  ;  Seunghwan Song  ;  Han Ki Park  ;  Young Hwan Park 
Citation
 Korean Journal of Thoracic and Cardiovascular Surgery, Vol.49(3) : 151-156, 2016 
Journal Title
 Korean Journal of Thoracic and Cardiovascular Surgery 
ISSN
 2233-601X 
Issue Date
2016
Keywords
Cardiopulmonary bypass ; Child ; Extracorporeal cardiopulmonary resuscitation ; Resuscitation
Abstract
Background : Survival of children experiencing cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR) is very poor. We sought to examine current era outcomes of extracorporeal CPR (ECPR) support for refractory arrest. Methods : Patients who were <18 years and underwent ECPR between November 2013 and January 2016 were including in this study. We retrospectively investigated patient medical records. Results : Twelve children, median age 6.6 months (range, 1 day to 11.7 years), required ECPR. patients’ diseases spanned several categories: congenital heart disease (n=5), myocarditis (n=2), respiratory failure (n=2), septic shock (n=1), trauma (n=1), and post-cardiotomy arrest (n=1). Cannulation sites included the neck (n=8), chest (n=3), and neck to chest conversion (n=1). Median duration of extracorporeal membrane oxygenation was five days (range, 0 to 14 days). Extracorporeal membrane oxygenation was successfully discontinued in 10 (83.3%) patients. Nine patients (75%) survived more than seven days after support discontinuation and four patients (33.3%) survived and were discharged. Causes of death included ischemic brain injury (n=4), sepsis (n=3), and gastrointestinal bleeding (n=1). Conclusion : ECPR plays a valuable role in children experiencing refractory cardiac arrest. The weaning rate is acceptable; however, survival is related to other organ dysfunction and the severity of ischemic brain injury. ECPR prior to the emergence of end-organ injury and prevention of neurologic injury might enhance survival.
Files in This Item:
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DOI
10.5090/kjtcs.2016.49.3.151
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Hwan(박영환)
Park, Han Ki(박한기) ORCID logo https://orcid.org/0000-0002-7472-7822
Song, Seung Hwan(송승환)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/152323
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