OC18 CURRENT OUTCOME OF VENO-ARTERIAL EXTRACORPOREAL MEMBRANE OXYGENTATION IN NEONATES AND INFANTS USING MAGNETIC LEVITATION CENTRIFUGAL PUMPS

Abstract

Background: Outcomes using first generation centrifugal pumps has been controversial, thus latest generation centrifugal pumps were developed in order to overcome mechanical properties of old era devices. Objective: The aim of this study was to assess the safety and efficacy of V-A ECMO for cardiac indications using standard and latest generation magnetic levitation centrifugal pumps. Methods: Between 09/2002 and 01/2017, 40 neonates and infants were supported using V-A ECMO for cardiac indication. There were 27 male and 13 female, with median age of 23 days (4 dys-12 mon) and a median body weight of 3.2 kg (1.9–12 kg; 11/40 < 2.5 kg). Results: Median duration of support was 72 h (24–672 h), with an overall weaning rate of 82% (33/40). Overall survival to discharge was 48% (19/40). Risk factors for hospital mortality included lower (<2.5 kg) body weight (p = 0.02) and rescue ECMO after cardiac repair (p = 0.03). During a median follow-up of 52 months (range 1–97 months), there were 4 (10%) late deaths and 2 late survivors with neurological sequelae. Comparison of weaning rate (5/7 versus 28/33, p = NS) and prevalence of renal failure requiring dialysis (4/7 versus 16/33, p = NS) were comparable between SP and ML ECMO groups. Patients supported with ML had a trend toward higher hospital survival (1/7 versus 18/33, p = 0.05) and significantly higher late survival (0/7 versus 15/33, p = 0.02). Conclusions: The present experience shows that V-A ECMO for cardiac indications using latest generation centrifugal pumps may further improve end-organ recovery, hospital and late survival, even in very low body weight newborn