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Recommendations for weaning off cardiopulmonary support in children with fulminant myocarditis

Hiroshi Kanamaru1, Kensuke Karasawa, Osamu Abe

  • 1Department of Pediatrics and Childhealth, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan. hkin@med.nihon-u.ac.jp

Circulation Journal : Official Journal of the Japanese Circulation Society
|September 27, 2007
PubMed

Insights

Cardiopulmonary support (CPS) can be safely used in children with fulminant myocarditis. Weaning CPS can occur before symptomatic bleeding, with improved biomarkers and oxygen saturation.

Area of Science:

  • Pediatric Cardiology
  • Critical Care Medicine
  • Cardiovascular Surgery

Background:

  • Fulminant myocarditis presents a critical challenge in pediatric care.
  • Cardiopulmonary support (CPS) is a vital intervention for severe cases.

Purpose of the Study:

  • To establish optimal recommendations for weaning children off cardiopulmonary support (CPS) in cases of fulminant myocarditis.

Main Methods:

  • Retrospective analysis of four pediatric patients with fulminant myocarditis treated with CPS.
  • Evaluation of factors influencing CPS weaning: bleeding, platelet count, CK-MB, echocardiography, and SvO2.

Main Results:

  • CPS was safely administered for a mean of 53.1 hours without circuit changes.
  • Bleeding occurred in three patients prior to CPS discontinuation.
  • Platelet nadir coincided with weaning; peak CK-MB decreased, and SvO2 improved upon weaning.

Conclusions:

  • Cardiopulmonary support is a viable treatment for pediatric fulminant myocarditis, allowing for safe circuit use.
  • CPS can be discontinued in pediatric fulminant myocarditis patients before symptomatic bleeding, with favorable biomarker and oxygen saturation trends.
Abstract

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