Abstract 70: Increased Survival After Extracorporeal Membrane Oxygenation Support in Children with Cardiac Disease

Abstract

Background: In children with cardiac disease ECMO has been used during cardiac arrest unresponsive to conventional CPR (E-CPR), in the cardiac operating room for failure to separate from cardiopulmonary bypass (OR-ECMO) and for low cardiac output syndrome (LCOS-ECMO). Though a life-saving intervention, the so far reported survival after ECMO ranges only from 38-51%. Methods/Results: Records of patients with cardiac disease who received ECMO support between 1/2006 - 12/2010 were evaluated. Measured outcomes included hospital and 28-day survival and transition to ventricular assist device (VAD) or transplant. There were 102 ECMO runs in 98 patients (41 E-CPR, 31 OR-ECMO and 26 LCOS-ECMO). Overall hospital survival was 76% and 28-day survival was 78%. In the E-CPR group more non-survivors (NS) had single ventricle (SV) anatomy, higher surgical complexity, persistent lactatemia and CNS injury. In the OR-ECMO, NS had longer ECMO run and worse ventricular function coming off ECMO. In the LCOS-ECMO, more NS had syndromic features, persistent lactatemia, decreased lung compliance and required plasma exchange (Tables 1, 2). The detailed outcomes of the 3 groups are shown in Table 3. Conclusion: An increased survival after ECMO support was noted in our patient population with cardiac disease. This increased survival was seen in all 3 groups including the E-CPR group where survival was > 75%.