Extracorporeal membrane oxygenation in pediatric cardiac surgery: A retrospective review of trends and outcomes in Scotland

Abstract

Introduction : Around 3.2%–8.4% of patients receive venoarterial (VA) extracorporeal membrane oxygenation (ECMO) support after pediatric cardiac surgery. The desired outcome is “bridgetorecovery” in most cases. There is no universally agreed protocol, and given the associated costs and complications rates, the decisions as of when and when not to institute VA ECMO are largely empirical. Methods : A retrospective review of the ECMO database at the Scottish Pediatric Cardiac Services (SPCS) was undertaken. Inclusion criterion encompassed all children (10 days, P = 0.177). Conclusions : Allcomers VA ECMO following pediatric cardiac surgery had survival to discharge rate of 44%. Elective “endofcase” ECMO carries better survival rates and therefore ECMO instituted early maybe advantageous. Prolonged ECMO support has a direct correlation with mortality.

Keywords

• Cardiac surgery
• extracorporeal membrane oxygenation
• pediatric
• postcardiotomy
• prognosis
• survival