Structured review of post-cardiotomy extracorporeal membrane oxygenation: Part 2-pediatric patients

Roberto Lorusso, Giuseppe Maria Raffa, Mariusz Kowalewski, Khalid Alenizy, Niels Sluijpers, Maged Makhoul, Daniel Brodie, Mike McMullan, I-Wen Wang, Paolo Meani, Graeme MacLaren, Heidi Dalton, Ryan Barbaro, Xaotong Hou, Nicholas Cavarocchi, Yih-Sharng Chen, Ravi Thiagarajan, Peta Alexander, Bahaaldin Alsoufi, Christian A BermudezAshish S Shah, Jonathan Haft, Lilia Oreto, David A D'Alessandro, Udo Boeken, Glenn Whitman

Research output: Contribution to journalArticle

Abstract

Veno-arterial extracorporeal membrane oxygenation (ECMO) is established therapy for short-term circulatory support for children with life-treating cardiorespiratory dysfunction. In children with congenital heart disease (CHD), ECMO is commonly used to support patients with post-cardiotomy shock or complications including intractable arrhythmias, cardiac arrest, and acute respiratory failure. Cannulation configurations include central, when the right atrium and aorta are utilized in patients with recent sternotomy, or peripheral, when cannulation of the neck or femoral vessels are used in non-operative patients. ECMO can be used to support any form of cardiac disease, including univentricular palliated circulation. Although veno-arterial ECMO is commonly used to support children with CHD, veno-venous ECMO has been used in selected patients with hypoxemia or ventilatory failure in the presence of good cardiac function. ECMO use and outcomes in the CHD population are mainly informed by single-center studies and reports from collated registry data. Significant knowledge gaps remain, including optimal patient selection, timing of ECMO deployment, duration of support, anti-coagulation, complications, and the impact of these factors on short- and long-term outcomes. This report, therefore, aims to present a comprehensive overview of the available literature informing patient selection, ECMO management, and in-hospital and early post-discharge outcomes in pediatric patients treated with ECMO for post-cardiotomy cardiorespiratory failure.
Original languageEnglish
JournalJournal of Heart and Lung Transplantation
DOIs
Publication statusPublished - Jul 17 2019

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    Lorusso, R., Raffa, G. M., Kowalewski, M., Alenizy, K., Sluijpers, N., Makhoul, M., Brodie, D., McMullan, M., Wang, I-W., Meani, P., MacLaren, G., Dalton, H., Barbaro, R., Hou, X., Cavarocchi, N., Chen, Y-S., Thiagarajan, R., Alexander, P., Alsoufi, B., ... Whitman, G. (2019). Structured review of post-cardiotomy extracorporeal membrane oxygenation: Part 2-pediatric patients. Journal of Heart and Lung Transplantation. https://doi.org/10.1016/j.healun.2019.07.004