Multicenter Experience With Mechanical Circulatory Support Using a New Diagonal Pump in 233 Children

Area of Science:

• Pediatric critical care medicine
• Biomedical engineering
• Cardiovascular support technologies

Background:

• Technological advancements in pediatric extracorporeal life support (ECLS) circuits are crucial for minimizing complications and improving patient outcomes.
• The Deltastream DP3 is a novel rotational pump designed for versatile flow rates in pediatric ECLS.

Purpose of the Study:

• To evaluate the efficacy and outcomes of the Deltastream DP3 rotational pump in pediatric patients requiring mechanical circulatory or respiratory support.
• To identify risk factors associated with adverse outcomes in this patient population.

Main Methods:

• A retrospective cohort study was conducted across seven pediatric centers.
• Patient data from 233 pediatric patients (median age 1.9 months) utilizing the DP3 system for various ECLS applications were analyzed.
• Outcomes including support duration, weaning rates, discharge rates, and complication incidence were examined.

Main Results:

• The DP3 system was used for veno-arterial ECMO (n=162), veno-venous ECMO (n=63), and as a ventricular assist device (n=8).
• Median support time was 5.5 days, with a weaning rate of 72.5% and a discharge home rate of 62% (pulmonary) vs. 55% (cardiac).
• Complications included bleeding (33%), renal replacement therapy (28%), and pump/oxygenator exchange (26%). Survival to discharge after extracorporeal cardiopulmonary resuscitation was 37.5% (n=24).

Conclusions:

• The Deltastream DP3 pump demonstrated effectiveness across diverse pediatric mechanical circulatory and respiratory support scenarios, achieving favorable survival rates.
• System exchange, kidney failure, and on-support complications were identified as significant risk factors for poor outcomes.
• Further research may optimize management strategies to mitigate identified risks and enhance patient outcomes.