Document Detail

Outcomes of Infants Weighing Three Kilograms or Less Requiring Extracorporeal Membrane Oxygenation After Cardiac Surgery.
MedLine Citation:
PMID:  22921239     Owner:  NLM     Status:  Publisher    
BACKGROUND: Extracorporeal membrane oxygenation (ECMO) is the most common form of cardiac support for postcardiotomy cardiac failure in children. While its benefits have been thoroughly explored in infants weighing more than 3kg, similar analyses are lacking in lower weight neonates. This single-center study investigated outcomes and risks for poor survival among infants weighing 3 kg or less. METHODS: A retrospective review of infants 3 kg or less who required postcardiotomy ECMO support was performed (January 1, 1999 to December 31, 2010). Primary outcome was 30-day survival after decannulation. Factors analyzed for association with poor outcome included demographics, cardiac anatomy, bypass and circulatory arrest times, total ECMO support time, postoperative lactate, inotrope use, and need for renal replacement therapy. RESULTS: During the study period, 64 patients weighing 3 kg or less required postcardiotomy ECMO. Median gestational age and age at ECMO initiation were 38 weeks (interquartile range, 36 to 39) and 7 days (interquartile range, 4 to 9), respectively, with median ECMO support time of 164 hours (interquartile range, 95 to 231). Overall 30-day survival after decannulation was 33%. Factors associated with poor outcome were longer duration of support (231 hours or more, 12% survival, versus less than 231 hours, 40% survival; p = 0.05) and renal replacement therapy (n = 36, survival 17% versus 54%; p = 0.002). Multivariable regression analysis identified renal replacement therapy as the only independent factor associated with poor survival (odds ratio 4.3, 95% confidence interval: 1.3 to 14.9, p = 0.02). CONCLUSIONS: For infants weighing 3 kg or less, 30-day survival after decannulation after cardiac ECMO is poor. Factors associated with poor prognosis were need for renal replacement therapy and longer duration of ECMO support. These findings may provide a useful guide for medical decision making among this unique, high-risk patient group.
Priya Bhat; Jennifer C Hirsch; Sarah Gelehrter; Elaine Cooley; Janet Donohue; Karen King; Robert J Gajarski
Related Documents :
25031799 - Massive cardiomegaly due to dilated cardiomyopathy causing bronchial obstruction in an ...
3957589 - In vivo 31p-mr spectroscopy of the liver in the infant rabbit to study the effect of hy...
7680729 - Development of human intrahepatic peribiliary glands. histological, keratin immunohisto...
6169059 - Alpha-fetoprotein in infantile obstructive jaundice in comparison with the normal ranges.
8533109 - Descriptive epidemiology of alimentary tract atresia.
1353049 - Complications associated with total parenteral nutrition in infants with short bowel sy...
3761089 - Increased urinary excretion of inorganic sulfate in premature infants fed bovine milk p...
25031799 - Massive cardiomegaly due to dilated cardiomyopathy causing bronchial obstruction in an ...
20438919 - Correlation of complex ascites with intestinal gangrene and perforation in neonates wit...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-23
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  -     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.
University of Michigan Congenital Heart Center, C.S. Mott Children's Hospital, Ann Arbor, Michigan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Perventricular Device Closure of Doubly Committed Subarterial Ventral Septal Defect Through Left Ant...
Next Document:  Mechanical circulatory support pathways that maximize post-heart transplant survival.