Faculty Collaboration Database

Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg 1999 Mar;117(3):529-42

Date

02/27/1999

Pubmed ID

10047657

DOI

10.1016/s0022-5223(99)70333-8

Scopus ID

2-s2.0-0032979259 (requires institutional sign-in at Scopus site)   228 Citations

Abstract

OBJECTIVE: To review the experience from a single center that uses both extracorporeal membrane oxygenation and ventricular assist devices for children with cardiac disease requiring mechanical circulatory support.

METHODS: A retrospective chart review was performed for all pediatric patients with cardiac disease who required support with extracorporeal membrane oxygenation or ventricular assist devices. Statistical analysis of the impact of multiple clinical parameters on survival was performed.

RESULTS: From 1987 through 1996 we provided mechanical circulatory support for children with a primary cardiac diagnosis using extracorporeal membrane oxygenation (67 patients) and ventricular assist devices (29 patients). Twenty-seven of 67 (40.3%) patients supported with extracorporeal membrane oxygenation and 12 of 29 (41.4%) patients supported with ventricular assist devices survived to hospital discharge. Failure of return of ventricular function within 72 hours of the institution of support was an ominous sign in patients supported with either modality. Univariate analysis revealed the serum pH at 24 hours of support, the serum bicarbonate at 24 hours of support, the urine output over the first 24 hours of support, and the development of renal failure to have a statistically significant association with survival in children supported with extracorporeal membrane oxygenation. None of the clinical parameters evaluated by univariate analysis were significantly associated with survival in the patients supported with ventricular assist devices.

CONCLUSIONS: Extracorporeal membrane oxygenation and ventricular assist devices represent complementary modalities of mechanical circulatory support that can both be used effectively in children with cardiac disease.

Author List

Duncan BW, Hraska V, Jonas RA, Wessel DL, Del Nido PJ, Laussen PC, Mayer JE, Lapierre RA, Wilson JM

Author

Viktor Hraska MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Child
Child, Preschool
Extracorporeal Membrane Oxygenation
Heart Diseases
Heart-Assist Devices
Humans
Infant
Infant, Newborn
Multivariate Analysis
Retrospective Studies
Survival Rate
Ventricular Function