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ECPR for prolonged Pediatric Cardiac Arrest, an outcome without major neurological compromise
Laura Gutiérrez-Soriano1, Eduardo Becerra Zapata2, Nicolas Maya Trujillo2
1Cardiovascular Anesthesiologist Anesthesiology Department, Fundación Cardioinfantil, 1113111 Bogota, Colombia.
Insights
Pediatric in-hospital cardiac arrest (IHCA) survival has improved, with extracorporeal membrane oxygenation (ECMO) aiding recovery in complex pediatric cardiac cases. This case highlights ECMO
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Cardiovascular Surgery
Background:
- Pediatric in-hospital cardiac arrest (IHCA) affects 1-6% of pediatric intensive care unit admissions.
- Survival rates for pediatric IHCA have risen to 35% over 25 years.
- Extracorporeal membrane oxygenation (ECMO) is a key rescue therapy for refractory cardiac arrest.
Observation:
- A 4-month-old infant with ventricular septal defects and left heart enlargement underwent corrective surgery.
- The patient experienced complications leading to prolonged cardiac arrest post-surgery.
- Extracorporeal membrane oxygenation (ECMO) was initiated as a life-saving measure.
Findings:
- The case demonstrates the successful application of ECMO in a pediatric patient with complex congenital heart disease following IHCA.
- ECMO provided crucial circulatory and respiratory support during a critical period.
Implications:
- This case underscores the vital role of ECMO in improving outcomes for pediatric patients with IHCA, especially those with underlying cardiac conditions.
- It highlights the importance of advanced life support strategies in pediatric cardiac critical care.
Abstract:
Pediatric in-hospital cardiac arrest (IHCA) has been reported in 1-3% of pediatric intensive care unit (ICU) admissions and up to 6% of children admissions to the cardiac ICU. In the last 25 years, the survival to hospital discharge after pediatric IHCA has improved from 9% to 13.7% up to 35%. The improvement in outcomes was attributed in part to the application of ECMO as a rescue strategy when prolonged conventional CPR cannot restore spontaneous circulation. We report a case of a 4-month-old patient with a history of ventricular and septal defects, with left to right shunt and enlargement of left heart chambers that underwent surgery for the closure of the atrial and septal defects, and experienced complications that led to the use of ECMO in response to a prolonged cardiac arrest.
