Structured review of post-cardiotomy extracorporeal membrane oxygenation: Part 2-pediatric patients

Roberto Lorusso, Giuseppe Maria Raffa*, Mariusz Kowalewski, Khalid Alenizy, Niels Sluijpers, Maged Makhoul, Daniel Brodie, Mike McMullan, I-Wen Wang, Paolo Meani, Graeme MacLaren, Heidi Dalton, Ryan Barbaro, Xaotong Hou, Nicholas Cavarocchi, Yih-Sharng Chen, Ravi Thiagarajan, Peta Alexander, Bahaaldin Alsoufi, Christian A. BermudezAshish S. Shah, Jonathan Haft, Lilia Oreto, David A. D'Alessandro, Udo Boeken, Glenn Whitman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Citations (Web of Science)

Abstract

Veno-arterial extracorporeal membrane oxygenation (ECMO) is established therapy for short-term circulatory support for children with life-treating cardiorespiratory dysfunction. In children with congenital heart disease (CHD), ECMO is commonly used to support patients with post-cardiotomy shock or complications including intractable arrhythmias, cardiac arrest, and acute respiratory failure. Cannulation configurations include central, when the right atrium and aorta are utilized in patients with recent sternotomy, or peripheral, when cannulation of the neck or femoral vessels are used in non-operative patients. ECMO can be used to support any form of cardiac disease, including univentricular palliated circulation. Although veno-arterial ECMO is commonly used to support children with CHD, venovenous ECMO has been used in selected patients with hypoxemia or ventilatory failure in the presence of good cardiac function. ECMO use and outcomes in the CHD population are mainly informed by single-center studies and reports from collated registry data. Significant knowledge gaps remain, including optimal patient selection, timing of ECMO deployment, duration of support, anti-coagulation, complications, and the impact of these factors on short- and long-term outcomes. This report, therefore, aims to present a comprehensive overview of the available literature informing patient selection, ECMO management, and in-hospital and early post-discharge outcomes in pediatric patients treated with ECMO for post-cardiotomy cardiorespiratory failure. (C) 2019 International Society for Heart and Lung Transplantation. All rights reserved.

Original languageEnglish
Pages (from-to)1144-1161
Number of pages18
JournalJournal of Heart and Lung Transplantation
Volume38
Issue number11
DOIs
Publication statusPublished - Nov 2019

Keywords

  • extracorporeal membrane oxygenation
  • cardiac surgical procedures
  • child
  • congenital
  • post-cardiotomy circulatory assistance
  • post-cardiotomy cardiogenic shock
  • PEDIATRIC CARDIAC-SURGERY
  • MECHANICAL CIRCULATORY SUPPORT
  • RESPIRATORY-DISTRESS-SYNDROME
  • CONGENITAL HEART-DISEASE
  • LIFE-SUPPORT
  • SINGLE-VENTRICLE
  • CARDIOPULMONARY-RESUSCITATION
  • RISK-FACTORS
  • RESIDUAL LESIONS
  • TERM SURVIVAL

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