Korean J Thorac Cardiovasc Surg.  2016 Jun;49(3):151-156. 10.5090/kjtcs.2016.49.3.151.

Results of Extracorporeal Cardiopulmonary Resuscitation in Children

• Shin HJ
• Song S
• Park HK
• Park YH

• KMID: 2285802
• DOI: http://doi.org/10.5090/kjtcs.2016.49.3.151

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.

Keyword

Extracorporeal cardiopulmonary resuscitation; Child; Cardiopulmonary bypass; Resuscitation

MeSH Terms

Brain Injuries
Cardiopulmonary Bypass
Cardiopulmonary Resuscitation*
Catheterization
Cause of Death
Child*
Extracorporeal Membrane Oxygenation
Heart Arrest
Heart Defects, Congenital
Hemorrhage
Humans
Medical Records
Myocarditis
Neck
Respiratory Insufficiency
Resuscitation
Retrospective Studies
Sepsis
Shock, Septic
Thorax
Weaning