Advances in mechanical circulatory support therapy for fulminant myocarditis in children

Abstract

Fulminant myocarditis in children often has a transient viral prodrome, which is characterized by acute onset and lack of specificity in the early stage.It is prone to deteriorate in serious cardiac pump dysfunction and arrhythmia, which may lead to cardiogenic shock and even sudden cardiac death.Some patients are given the pharmacologic treatment of large doses of inotropes, corticosteroids, intravenous immunoglobulin, antiarrhythmic agents as well as other therapies such as mechanical ventilation, temporary pacemaker, but the circulatory failure still can not be improved, leading to irreversible heart damage and life-threatening.It has been reported that timely mechanical circulatory support for critically ill children can effectively promote the recovery of cardiac pump function, reduce mortality and improve prognosis.Mechanical circulatory assist devices mainly inclucle extracorporeal membrane oxygenation(ECMO), intra aortic balloon pump(IABP), left ventricular assist device(LVAD)or double ventricular assist device(Bi-VAD). In view of the limited understanding of the technology in the field of pediatrics in our country, this has not been used extensively.This article reviews the progress of FM treatment in children with mechanical circulatory support. Key words: Fulminant myocarditis; Mechanical assistant support; Extracorporeal membrane oxygenation; Intra-aortic balloon pump; Left ventricular assist device