Experience with Extracorporeal Life Support in Pediatric Patients after Cardiac Surgery
|Issue Date:||31-Jul-2005||Publisher:||臺北市：國立臺灣大學醫學院外科||Start page/Pages:||-||Source:||ASAIO Journal 2005(51); 517–521||Abstract:||
Extracorporeal life support (ECLS) had been successfully used
in neonatal respiratory failure, but cardiac ECLS has been
used increasingly in recent years. The purpose of this study
was to review our experience in pediatric patients supported
by ECLS for postoperative circulatory failure and to analyze
the factors associated with mortality. Between January 1999
and December 2004, 68 pediatric patients (< 18 years old)
who received ECLS within 7 days after cardiac surgery at the
National Taiwan University Hospital were included in this
study. The overall survival rate of this cohort was 32.4%. Age
and gender did not affect survival. Patients with separate
biventricular physiology had a higher probability of survival
than those with systemic-pulmonary shunt or cavopulmonary
anastomosis (41.3% vs. 13.6%, p < 0.05). Acute renal failure
during ECLS was significantly associated with mortality (83%
vs. 33.5%, p < 0.001). After ECLS initiation, the lowest
lactate levels on the second to fourth days were lower in
survivors than in nonsurvivors (2.4 vs. 3.3 mmol/L, p < 0.05).
There was a trend toward a better survival in the most recent
2 years in comparison with the previous 4 years (47.6% vs.
25.5%, p 0.07), although this trend did not reach statistical
significance. In conclusion, nonbiventricular physiology,
acute renal failure, and high blood lactate levels after ECLS
increased the risk of mortality for pediatric patients requiring
ECLS for postoperative cardiac support.
|Appears in Collections:||醫學系|
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