|Title:||Experience with extracorporeal life support in pediatric patients after cardiac surgery||Authors:||Huang S.-C.
|Issue Date:||2005||Journal Volume:||51||Journal Issue:||5||Start page/Pages:||517-521||Source:||ASAIO Journal||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.
|ISSN:||1058-2916||DOI:||10.1097/01.mat.0000177215.32770.e6||metadata.dc.subject.other:||Cardiovascular surgery; Patient monitoring; Physiological models; Pulmonary diseases; Risk assessment; Statistical methods; Cardiac surgery; Circulatory failure; Extracorporeal life support (ECLS); Mortality; Pediatrics; lactic acid; acute kidney failure; adolescent; cohort analysis; conference paper; controlled study; extracorporeal oxygenation; female; heart failure; heart surgery; human; lactate blood level; lung arteriovenous shunt; major clinical study; male; mortality; postoperative care; postoperative complication; preschool child; respiratory failure; school child; surgical risk; survival rate; Taiwan; treatment indication; Acute Disease; Adolescent; Cardiac Output, Low; Cause of Death; Child; Child, Preschool; Cohort Studies; Extracorporeal Membrane Oxygenation; Female; Follow-Up Studies; Heart Defects, Congenital; Heart Massage; Hospital Mortality; Humans; Infant; Infant, Newborn; Kidney Failure; Male; Odds Ratio; Retrospective Studies; Risk Factors; Survival Rate; Taiwan; Thoracic Surgery; Time Factors; Treatment Outcome
|Appears in Collections:||醫學系|
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