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Extracorporeal membrane oxygenation in children with heart disease and genetic syndromes

Santosh C Uppu1, Sunali Goyal, Jeffrey M Gossett

  • 1Divisions of Pediatric Cardiology, University of Arkansas Medical Center, Little Rock, Arkansas, USA.

ASAIO Journal (American Society for Artificial Internal Organs : 1992)
|December 13, 2012
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) in children with heart disease and genetic syndromes shows similar survival and length of stay compared to those without syndromes. Renal issues impacted mortality in the genetic group, but ECMO remains a viable option.

Area of Science:

  • Pediatric Cardiology
  • Medical Genetics
  • Critical Care Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support measure for critically ill patients.
  • Genetic syndromes can complicate cardiac conditions in children.
  • Outcomes of ECMO in pediatric patients with both heart disease and genetic syndromes require further evaluation.

Purpose of the Study:

  • To assess the morbidity and mortality associated with ECMO in children with congenital heart disease and genetic syndromes.
  • To compare ECMO outcomes between children with and without genetic abnormalities.

Main Methods:

  • Retrospective review of pediatric patients undergoing ECMO from January 2000 to March 2012.
  • Data collection included demographics, medical history, organ dysfunction, and outcomes (length of stay, survival).
  • Comparison of outcomes between children with and without genetic syndromes.

Main Results:

  • 43 ECMO runs in children with genetic syndromes versus 334 without.
  • Children with genetic syndromes were older at cannulation.
  • Hospital length of stay and mortality rates were similar between groups.
  • Renal insufficiency and dialysis need were associated with mortality in the genetic group.
  • 56% of children with genetic syndromes survived to hospital discharge, with 10 patients alive at follow-up.

Conclusions:

  • ECMO is a feasible treatment for children with heart disease and genetic syndromes.
  • Survival rates are comparable, and complication rates are low.
  • Careful monitoring for renal complications is crucial in this patient population.

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