Merkle, Julia, Azizov, Farid, Sabashnikov, Anton ORCID: 0000-0002-6289-1035, Weixler, Viktoria, Weber, Carolyn, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Eghbalzadeh, Kaveh, Kroener, Axel, Zeriouh, Mohamed, Wahlers, Thorsten and Bennink, Gerardus (2019). Pediatric patients requiring extracorporeal membrane oxygenation in heart failure: 30-day outcomes; mid- and long-term survival. A single center experience. Artif. Organs, 43 (10). S. 966 - 976. HOBOKEN: WILEY. ISSN 1525-1594

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Abstract

Nowadays, an increasing number of neonatal and pediatric patients with severe heart failure benefits from extracorporeal membrane oxygenation (ECMO) support. A total of 39 pediatric patients needed venoarterial ECMO (vaECMO) support in our department between January 2008 and December 2016. Patients were retrospectively divided in two groups: 30-day survivor group (17 patients) and 30-day nonsurvivor group (22 patients). Outcome and factors predictive for 30-day mortality and mid- as well as long-term survival up to 7-year follow-up were analyzed by univariate analysis and Kaplan-Meier survival estimation. Basic demographics and preoperative characteristics did not differ between groups (P > 0.05). 67% of patients were successfully weaned off ECMO and 44% survived 30-day after ECMO application. After 7-year follow-up 28% of pediatric patients were alive. Thirty-day survivors were significantly more likely to undergo elective cardiac surgery (P = 0.001), whereas significantly more 30-day nonsurvivors underwent urgent surgery (P = 0.004). Odds of incidence of catecholamine refractory circulatory failure, failed myocardial recovery, and cerebral edema was significantly higher in 30-day nonsurvivor group (41.6-fold, 16-fold, and 2.5-fold, respectively). Kaplan-Meier survival estimation analysis revealed significant differences in terms of mid- and long-term survival among neonates, infants, toddlers, and preadolescents (Breslow P = 0.037 and Log-Rank P = 0.028, respectively). vaECMO provides an efficient therapy option for life-threatening heart disorders in neonates and pediatric patients being at high risk for myocardial failure leading to circulatory arrest. Urgency of surgery effected on higher mortality, but there was no difference in terms of mortality in 30-day survivor group in comparison to 30-day nonsurvivor group among neonates, infants, toddlers, and preadolescents.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Merkle, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Azizov, FaridUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabashnikov, AntonUNSPECIFIEDorcid.org/0000-0002-6289-1035UNSPECIFIED
Weixler, ViktoriaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weber, CarolynUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Djordjevic, IlijaUNSPECIFIEDorcid.org/0000-0002-5810-8626UNSPECIFIED
Eghbalzadeh, KavehUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kroener, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Zeriouh, MohamedUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bennink, GerardusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-132196
DOI: 10.1111/aor.13501
Journal or Publication Title: Artif. Organs
Volume: 43
Number: 10
Page Range: S. 966 - 976
Date: 2019
Publisher: WILEY
Place of Publication: HOBOKEN
ISSN: 1525-1594
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
MORTALITYMultiple languages
Engineering, Biomedical; TransplantationMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/13219

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