Early outcomes after post-cardiotomy extracorporeal membrane oxygenation in paediatric patients: a contemporary, binational cohort study.

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  • Additional Information
    • Corporate Authors:
      ANZCORS Collaborative
    • Source:
      Publisher: Oxford University Press Country of Publication: Germany NLM ID: 8804069 Publication Model: Print Cited Medium: Internet ISSN: 1873-734X (Electronic) Linking ISSN: 10107940 NLM ISO Abbreviation: Eur J Cardiothorac Surg Subsets: MEDLINE
    • Publication Information:
      Publication: 2012-: Oxford, England : Oxford University Press
      Original Publication: [Berlin] : Springer International ; [Secaucus, NJ, USA : Springer-Verlag New York Inc., distributor, c1987-
    • Subject Terms:
      Extracorporeal Membrane Oxygenation*/adverse effects ; Extracorporeal Membrane Oxygenation*/methods ; Cardiac Surgical Procedures*/adverse effects ; Cardiac Surgical Procedures*/mortality ; Postoperative Complications*/epidemiology ; Postoperative Complications*/etiology ; Heart Defects, Congenital*/surgery ; Heart Defects, Congenital*/mortality ; Hospital Mortality*; Humans ; Retrospective Studies ; Male ; Female ; Infant ; Infant, Newborn ; Child, Preschool ; Child ; New Zealand/epidemiology ; Australia/epidemiology ; Risk Factors ; Treatment Outcome ; Adolescent ; Registries
    • Abstract:
      Objectives: The aim of this study was to assess the early outcomes and risk factors of paediatric patients requiring extracorporeal membrane oxygenation after cardiac surgery (post-cardiotomy).
      Methods: Retrospective binational cohort study from the Australia and New Zealand Congenital Outcomes Registry for Surgery database. All patients younger than 18 years of age who underwent a paediatric cardiac surgical procedure from 1 January 2013 to 31 December 2021 and required post-cardiotomy extracorporeal membrane oxygenation (PC-ECMO) in the same hospital admission were included in the study.
      Results: Of the 12 290 patients included in the study, 376 patients required post-cardiotomy ECMO (3%). Amongst these patients, hospital mortality was 35.6% and two-thirds of patients experienced a major complication. Hypoplastic left heart syndrome was the most common diagnosis (17%). The Norwood procedure and modified Blalock-Taussig shunts had the highest incidence of requiring PC-ECMO (odds ratio of 10 and 6.8 respectively). Predictors of hospital mortality after PC-ECMO included single-ventricle physiology, intracranial haemorrhage and chylothorax.
      Conclusions: In the current era, one-third of patients who required PC-ECMO after paediatric cardiac surgery in Australia and New Zealand did not survive to hospital discharge. The Norwood procedure and isolated modified Blalock-Taussig shunt had the highest incidence of requiring PC-ECMO. Patients undergoing the Norwood procedure had the highest mortality (48%). Two-thirds of patients on PC-ECMO developed a major complication.
      (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)
    • Contributed Indexing:
      Investigator: D Andrews; J Artrip; J Brink; C Brizard; B Davies; K Finucane; J Johnson; M Liava'a; I Nicholson; A Patukale
      Keywords: Congenital; Extracorporeal membrane oxygenation; Paediatric
    • Publication Date:
      Date Created: 20240405 Date Completed: 20240424 Latest Revision: 20240502
    • Publication Date:
      20240503
    • Accession Number:
      10.1093/ejcts/ezae124
    • Accession Number:
      38579237