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Factors affecting the outcome of extracorporeal membrane oxygenation following paediatric cardiac surgery

Published online by Cambridge University Press:  20 November 2019

Ahmed M. Dohain Open the ORCID record for Ahmed M. Dohain [Opens in a new window] ,
Gaser Abdelmohsen ,
Ahmed A. Elassal ,
Ahmed F. ElMahrouk  and
Osman O. Al-Radi
Ahmed M. Dohain*
Affiliation:
Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Giza, Egypt
Gaser Abdelmohsen
Affiliation:
Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Giza, Egypt
Ahmed A. Elassal
Affiliation:
Cardiac Surgery Division, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia Department of Cardiothoracic Surgery, Zagazig University, Zagazig, Egypt
Ahmed F. ElMahrouk
Affiliation:
Department of Cardiothoracic Surgery, Tanta University, Tanta, Egypt Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
Osman O. Al-Radi
Affiliation:
Cardiac Surgery Division, Department of Surgery, King Abdulaziz University, Jeddah, Saudi Arabia Department of Cardiothoracic Surgery, King Faisal Specialist Hospital and Research Centre, Jeddah, Saudi Arabia
*
Author for correspondence: A. M. Dohain, Pediatric Cardiology Division, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia; Pediatric Cardiology Division, Department of Pediatrics, Cairo University, Giza, Egypt. Tel: +966 541 611 496; Fax: +966 126 952 538; E-mails: adohain@yahoo.com; amdohain@kau.edu.sa
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Abstract

Background:

Extracorporeal membrane oxygenation has been widely used after paediatric cardiac surgery due to increasing complex surgical repairs in neonates and infants having complex CHDs.

Materials and methods:

We reviewed retrospectively the medical records of all patients with CHD requiring corrective or palliative cardiac surgery at King Abdulaziz University Hospital that needed extracorporeal membrane oxygenation support between November 2015 and November 2018.

Results:

The extracorporeal membrane oxygenation population was 30 patients, which represented 4% of 746 children who had cardiac surgery during this period. The patients’ age range was from 1 day to 20.33 years, with a median age of 6.5 months. Median weight was 5 kg (range from 2 to 53 kg). Twenty patients were successfully decannulated (66.67%), and 12 patients (40%) were survived to hospital discharge. Patients with biventricular repair tended to have better survival rate compared with those with single ventricle palliation (55.55 versus 16.66%, p-value 0.058). During the first 24 hours of extracorporeal membrane oxygenation support, the flow rate was significantly reduced after 4 hours of extracorporeal membrane oxygenation connection in successfully decannulated patients.

Conclusion:

Survival to hospital discharge in patients requiring extracorporeal membrane oxygenation support after paediatric cardiac surgery was better in those who underwent biventricular repair than in those who had univentricular palliation. Capillary leak on extracorporeal membrane oxygenation could be a risk of mortality in patients after paediatric cardiac surgery.

Keywords

Extracorporeal membrane oxygenationCHDcardiac surgerypaediatricsurvival
Type
Original Article
Information
Cardiology in the Young , Volume 29 , Issue 12 , December 2019 , pp. 1501 - 1509
Copyright
© Cambridge University Press 2019 

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