Clinical characteristics and long-term outcomes of Venoarterial extracorporeal membrane oxygenation in children with congenital heart disease

IF 2.2 3区医学 Q3 ENGINEERING, BIOMEDICAL

Artificial organs Pub Date : 2024-11-15 DOI:10.1111/aor.14895

Xindi Yu, Yinyu Yang, Zheng Guo, Jia Shen, Li Xie, Zhuoming Xu, Haibo Zhang, Wei Zhang, Wei Wang

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引用次数: 0

Abstract

Objectives

To analyze the clinical outcomes of extracorporeal membrane oxygenation (ECMO) support in children with congenital heart disease (CHD) after surgery and explore the risk factors associated with mortality during long-term follow-up for 3–5 years.

Methods

We conducted a retrospective observational study at Shanghai Children Medical Center (SCMC) from 2017 to 2021 and reviewed the clinical results and laboratory findings of 188 CHD patients who received ECMO support during this period.

Results

The 5-year overall survival rate was 56.38% (106/188) among CHD patients who received ECMO support. Kaplan–Meier curve showed residual anatomical malformation (RAM) (p < 0.0001), gastrointestinal bleeding (p = 0.019), single ventricular (SV) (p = 0.028), and pre-ECMO lactate level >10 mmol/L (p < 0.0001) were significantly associated with higher mortality in follow-up. Cox analysis identified RAM (p = 0.039) and pre-ECMO lactate level >10 mmol/L (p < 0.001) as independent risk factors for overall survival. Conversely, a minimum platelet count ≥50 × 10⁹/L (p < 0.001) was found to be a protective factor. Moreover, a competing risk model showed that a CPR time ≥60 min (p < 0.001) was identified as a risk factor for death in patients who failed to be discharged from the hospital.

Conclusions

Our study showed characteristics of long-term follow-up patients and revealed several risk factors associated with mortality in children with CHD who received ECMO support. These findings can provide valuable insights for clinical decision-making and contribute to improving patient outcomes.

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先天性心脏病患儿静脉体外膜氧合的临床特点和长期疗效。

目的分析先天性心脏病（CHD）患儿术后体外膜肺氧合（ECMO）支持的临床效果，并探讨3-5年长期随访中与死亡率相关的风险因素：2017年至2021年，我们在上海儿童医学中心（SCMC）开展了一项回顾性观察研究，回顾性分析了在此期间接受ECMO支持的188例CHD患者的临床结果和实验室检查结果：接受ECMO支持的CHD患者5年总生存率为56.38%（106/188）。Kaplan-Meier 曲线显示残留解剖畸形（RAM）（p 10 mmol/L （p 10 mmol/L （p 9/L （p 结论：我们的研究显示了长期随访患者的特征：我们的研究显示了长期随访患者的特征，并揭示了与接受 ECMO 支持的先天性心脏病患儿死亡率相关的几个风险因素。这些发现可为临床决策提供有价值的见解，并有助于改善患者的预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Artificial organs 工程技术-工程：生物医学

CiteScore

4.30

自引率

12.50%

发文量

303

审稿时长

4-8 weeks

期刊介绍： Artificial Organs is the official peer reviewed journal of The International Federation for Artificial Organs (Members of the Federation are: The American Society for Artificial Internal Organs, The European Society for Artificial Organs, and The Japanese Society for Artificial Organs), The International Faculty for Artificial Organs, the International Society for Rotary Blood Pumps, The International Society for Pediatric Mechanical Cardiopulmonary Support, and the Vienna International Workshop on Functional Electrical Stimulation. Artificial Organs publishes original research articles dealing with developments in artificial organs applications and treatment modalities and their clinical applications worldwide. Membership in the Societies listed above is not a prerequisite for publication. Articles are published without charge to the author except for color figures and excess page charges as noted.