Related Experiment Video
Updated: Jun 27, 2026
Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death
Published on: August 15, 2022
Extracorporeal membrane oxygenation circulatory support after congenital cardiac surgery
Yasuyuki Suzuki1, Sanae Yamauchi, Kazuyuki Daitoku
1Department of Thoracic and Cardiovascular Surgery, Hirosaki University School of Medicine, Hirosaki, Aomori, Japan. ysuzuki@cc.hirosaki-u.ac.jp
Insights
Extracorporeal membrane oxygenation (ECMO) effectively supports pediatric cardiac surgery patients with low cardiac output and hypoxemia. Postoperative ECMO showed better outcomes for respiratory insufficiency than heart failure in this cohort.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Extracorporeal membrane oxygenation (ECMO) is a vital mechanical circulatory support for pediatric patients experiencing low cardiac output and hypoxemia post-cardiac surgery.
- This study retrospectively evaluates the efficacy of postoperative ECMO in a cohort of pediatric patients undergoing congenital cardiac surgery.
Observation:
- Seven pediatric patients (median age 30 months) received postoperative ECMO between 2002 and 2008.
- Four patients had complete repairs (including Fontan circulation), and four had palliative repairs.
- ECMO initiation occurred intraoperatively in four patients and postoperatively in the ICU for three.
Findings:
- Five out of seven patients survived to hospital discharge after ECMO support.
- The mean ECMO duration for survivors was 121 hours.
- Bleeding was the primary complication despite controlled activated clotting time; respiratory insufficiency cases had better outcomes than heart failure cases.
Implications:
- Postoperative ECMO demonstrates effectiveness in managing heart failure and respiratory insufficiency following pediatric congenital cardiac surgery.
- ECMO offers a viable support strategy, with particular benefit noted for respiratory failure.
- Further research into optimizing ECMO management and mitigating complications like bleeding is warranted.
Abstract:
Extracorporeal membrane oxygenation (ECMO) is widely used for circulatory support in pediatric cardiac patients with low cardiac output and hypoxemia after cardiac surgery. We evaluated retrospectively, the efficacy of postoperative ECMO support following congenital cardiac surgery in our hospital. From April 2002 to February 2008, seven patients (median age 30 months) received postoperative mechanical support. Three had complete repair including Fontan circulation and four had palliative repair. In four patients, ECMO was initiated in the operating room, in three patients in the intensive care unit, postoperatively. Of the seven patients, one died on ECMO (support withdrawn), one died shortly after ECMO was discontinued, and five were successfully weaned and survived to hospital discharge. One of the survivors died 4 months after the operation due to pneumonia and septic shock. The mean duration of ECMO support was 121 hours (in survivors). During ECMO, the major complication was bleeding, despite adequate control of activated clotting time. We conclude that ECMO support for heart failure and respiratory insufficiency after congenital cardiac surgery was effective, and the result of ECMO support for respiratory insufficiency was better than for heart failure.
Related Concept Videos
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:29Cardiomyopathy V: Interprofessional Care