Rescue ECMO in Infant with Congenital Heart Disease: Early Experience at a University Hospitals

Authors

  • Kriangkrai Tantiwongkosri Division of Cardiothoracic Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand.

Abstract

Background: Extracorporeal membrane oxygenator (ECMO) is one of challenging mechanical support devices that can increase a chance of survival in infant patients who undergo complicated congenital cardiac surgery, but cannot be separated from cardiopulmonary bypass. ECMO also rescues cardiac arrest patients after cardiac intervention or from other reasons. We would like to show our outcome in early experience.    
Methods: We retrospectively reviewed our medical records of all infant patients supported with ECMO after they underwent cardiac procedures between January 2011 and December 2013. Their demographic data, diagnosis, procedure variables, ECMO indication and duration, blood product administration, circuit-related complication, ICU length of stay, intubation period time, and perioperative outcome were analyzed.
Results: There were six patients (Male = 5, Female = 1) with congenital heart disease who received ECMO following cardiac intervention (n=2) or cardiac surgery (n=4). Four patients with post-cardiac surgery had a mean cardiopulmonary bypass time of 347.25 minutes (SD= 132.10, range 235-530 minutes) and a mean aortic cross-clamp time of 90.75minutes (SD=47.74, range 52-159 minutes). The median age of ECMO induction was 32 days (range 1-182 days) and the mean weight of patients at ECMO induction was 3.15 kg (SD=0.67, range 2.5-4.3 kg). All patients received venoarterial type of ECMO support. The reasons for rescue ECMO were post-cardiac arrest (n=1), inability to wean from cardiopulmonary bypass (n=3), pulmonary hypertension (n=1), and cardiogenic shock (n=1). Five of them were successfully weaned from ECMO. Overall Survival in this group was 50% (3 out of 6 patients). Sepsis, cardiomyopathy and pulmonary hypertension were causes of death.
Conclusion: ECMO is an efficacious method for rescuing some infant patients who undergo complex congenital heart surgery or cardiac intervention with critical unstable status or post-cardiac arrest.

Keywords: ECMO, congenital heart disease, infant

Downloads

Published

10-04-2015

How to Cite

Tantiwongkosri, K. (2015). Rescue ECMO in Infant with Congenital Heart Disease: Early Experience at a University Hospitals. Siriraj Medical Journal, 67(2). Retrieved from https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/55251

Issue

Vol. 67 No. 2 (2015): March-April

Section

Original Article

License

Users are free to share, copy, and redistribute all articles published in the Siriraj Medical Journal (SMJ) in any medium or format as long as you follow the following terms:

  • Attribution — You must give appropriate credit, provide a link to the material, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the publisher endorses you or your use.
  • NonCommercial — You may not use the material for commercial purposes.
  • NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material.
  • No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.