Related Experiment Videos
Extracorporeal membrane oxygenation for cardiac support in children
1Department of Cardiac Surgery, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Extracorporeal membrane oxygenation (ECMO) effectively supports children with severe cardiac failure, improving survival rates. Utilizing ECMO as a bridge to heart transplantation further enhances outcomes for pediatric patients.
Area of Science:
- Pediatric Cardiology
- Cardiovascular Surgery
- Critical Care Medicine
Background:
- Extracorporeal membrane oxygenation (ECMO) has been utilized for pediatric cardiac support since 1981.
- Initially, most pediatric cases involved post-cardiac operation support.
- Recent trends show increased ECMO use for cardiomyopathy and myocarditis, often as a bridge to transplantation.
Purpose of the Study:
- To evaluate the effectiveness of ECMO in pediatric patients with severe cardiac failure.
- To assess survival rates associated with ECMO support over time.
- To determine the impact of ECMO as a bridge to heart transplantation.
Main Methods:
- A retrospective review of 68 children who received ECMO for cardiac support between 1981 and 1994.
- Analysis of overall survival rates and survival in specific patient subgroups.
- Examination of outcomes for patients bridged to heart transplantation and those resuscitated after cardiac arrest.
Main Results:
- Overall survival for ECMO in pediatric cardiac failure was 38%, with recent survival increasing to 47%.
- In 14 children, ECMO served as a bridge to transplantation, resulting in 7 long-term survivors.
- ECMO resuscitation for sudden cardiac arrest in 11 children yielded a 53% long-term survival rate.
Conclusions:
- ECMO is an effective therapeutic option for severe pediatric cardiac failure.
- Improved patient selection and the integration of heart transplantation have significantly enhanced ECMO survival rates.
- ECMO offers a viable support strategy for critically ill pediatric cardiac patients.
Background:
Extracorporeal membrane oxygenation (ECMO) support for cardiac failure has been used in children since 1981 at the Children's Hospital in Pittsburgh. Most children required support after cardiac operations. Recently, however, a larger number of patients with decompensated cardiomyopathy or myocarditis have been supported with ECMO, which was used as a bridge to transplantation in most.
Methods:
From 1981 to 1994, 68 children were placed on ECMO for cardiac support.
Results:
The overall survival for the entire time period was 38%, with the more recent experience survival increased to 47%. In 14 children, ECMO was used as a bridge to transplantation, with 9 children receiving a heart transplant and 7 long-term survivors. Extracorporeal membrane oxygenation has also been used to resuscitate 11 children after sudden cardiac arrest, with a long-term survival of 53%.
Conclusions:
We conclude that ECMO support for severe cardiac failure is effective. Patient selection and the use of heart transplantation for intractable heart failure have improved the overall survival.