Thorac Cardiovasc Surg 2007; 55 - MP_2
DOI: 10.1055/s-2007-967296

Mid-term survival after continuous V-A-ECMO-support in pediatric patients

K Ntalakoura 1, K Zar 1, U Gottschalk 2, C Haun 3, F Lacour-Gayet 4, V Hraska 5, H Reichenspurner 6, R Cesnjevar 1
  • 1Universitäres Herzzentrum, Kinderherzchirurgie, Hamburg, Germany
  • 2Universitäres Herzzentrum, Kinderkardiologie, Hamburg, Germany
  • 3Deutsches Kinderherzzentrum St. Augustin, Kinderkardiologie, St. Augustin/Bonn, Germany
  • 4Denver Children's Hospital, Pediatric Cardiac Surgery, Denver/Colorado, United States of America
  • 5Deutsches Kinderherzzentrum St. Augustin, Kinderherzchirurgie, St. Augustin/Bonn, Germany
  • 6Universitäres Herzzentrum, Herzchirurgie, Hamburg, Germany

Aims: Retrospective single center evaluation of the results for ECMO-support in pediatric patients.

Methods: Between 01/2000 and 06/2006 thirty-one patients required ECMO-support for different indications. Settings where patients went on ECMO-support were postoperative low-output-syndrome (n=10; 32.3%), rapidly after resuscitation (n=12; 39.9%), impaired ventricular function due to arrhythmias (n=5; 16.1%) or respiratory failure (n=4; 12.9%).

Results: There were 12 (39.9%) early and 3 (9.7%) late deaths. Cause of death was predominantly cardiac (n=9; 60.0%). Four patients died because of severe bleeding (26.7%) and two patients died because of other causes (13.3%). Weaning from ECMO-support was possible in 21 (67.7%) of all our patients. Sixteen (76.2%) of these patients are currently alive and survived in the long-term. Quality of life is good in 14 (87.5%) patients, two patient are severely handicapped because of neurologic complications post ECMO explantation.

Conclusion: ECMO is nowerdays a common used tool for cardiac and respiratory support in pediatric patients. Indications and results have changed over time, but remain controversial. Success depends on recovery of impaired organ function, absence of bleeding and type of underlying disease. Neurologic complications with moderate to severe functional impairment are the most common sequelae, limiting functional long-term results.