Abstract
Objective To review multi-center experience on rescue use of extracorporeal membrane oxygenation(ECMO) in pediatric patients with acute fulminant myocarditis and to investigate its short-term outcome in China. Methods The survey was conducted in 28 tertiary hospitals in China mainland.All children<18 years who had been supported with non-open chest ECMO to rescue acute fulminant myocarditis in PICU were reviewed. Results Twenty-three of 63 patients with ECMO support were diagnosed acute fulminant myocarditis.Their mean age was(86.3±48.8)months, mean weight was(25.8±12.1)kg, and mean left ventricular ejection fraction was(39.5±15.6)%.Eighteen patients(78.3%) survived to discharge and 5 cases(21.7%) died.The average length of ECMO was(119.1±57.3)h, (110.6±42.7)h for survival, (150.0±93.8)h for nonsurvival.There was no statistically difference between survival and death in ECMO support time(P=0.41). The mean arterial pressure increased from(60.7±23.7)mmHg(1 mmHg=0.113 kPa) of the beginning to(72.1±9.8)mmHg at 24 h after ECMO treatment, and increase of mean arterial pressure was higher in the survival compared with the nonsurvival(P=0.04). The mean serum lactate decreased from(6.8±5.1)mmol/L at ECMO initiation to(2.9±2.6)mmol/L at 24 h after ECMO treatment, and decrease of serum lactate was higher in survival group compared to nonsurvival group(P<0.001). Twenty-one patients(91.3%) were decanulated from ECMO successfully.Three patients died within 30 days after ECMO support, and eighteen patients survived to hospital discharge.The overall survival rate was 78.3%.There were no significant difference between the death and the survival in ECMO support time(P=0.41) and medical cost(P=0.24). The most common complications during ECMO were bleeding and disfunction of oxygenator.Of the 18 survivors, 15 were followed up, 4 experienced obvious sequelae, and 2 had neurologic issues. Conclusion ECMO is an effective hemodynamic support treatment that confers better clinical outcome for pediatric patients with acute fulminant myocarditis. Key words: Acute fulminant myocarditis; Extracorporeal membrane oxygenation; Pediatric intensive care unit; Clinical application; Questionnaires,
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.