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ID 55300
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Itoh, Hideshi Department of Cardiovascular Surgery, Okayama University Hospital
Ichiba, Shingo Department of Cardiovascular Surgery, Okayama University Hospital
Ujike, Yoshihito Department of Cardiovascular Surgery, Okayama University Hospital
Kasahara, Shingo Department of Cardiovascular Surgery, Okayama University Hospital Kaken ID publons
Arai, Sadahiko Department of Cardiovascular Surgery, Okayama University Hospital
Sano, Shuji Department of Cardiovascular Surgery, Okayama University Hospital
Abstract
 Extracorporeal membrane oxygenation (ECMO) has emerged as an effective mechanical support following cardiac surgery with respiratory and cardiac failure. However, there are no clear indications for ECMO use after pediatric cardiac surgery. We retrospectively reviewed medical records of 76 pediatric patients [mean age, 10.8 months (0-86); mean weight, 5.16 kg (1.16-16.5)] with congenital heart disease who received ECMO following cardiac surgery between January 1997 and October 2010. Forty-five patients were treated with an aggressive ECMO approach (aggressive ECMO group, April 2005-October 2010) and 31 with a delayed ECMO approach (delayed ECMO group, January 1997-March 2005). Demographics, diagnosis, operative variables, ECMO indication, and duration of survivors and non-survivors were compared. Thirty-four patients (75.5%) were successfully weaned from ECMO in the aggressive ECMO group and 26 (57.7%) were discharged. Conversely, eight patients (25.8%) were successfully weaned from ECMO in the delayed ECMO group and two (6.5%) were discharged. Forty-five patients with shunted single ventricle physiology (aggressive: 29 patients, delayed: 16 patients) received ECMO, but only 15 (33.3%) survived and were discharged. The survival rate of the aggressive ECMO group was significantly better when compared with the delayed ECMO group (p<0.01). Also, ECMO duration was significantly shorter among the aggressive ECMO group survivors (96.5 ± 62.9 h, p<0.01). Thus, the aggressive ECMO approach is a superior strategy compared to the delayed ECMO approach in pediatric cardiac patients. The aggressive ECMO approach improved our outcomes of neonatal and pediatric ECMO.
Keywords
Extracorporeal membrane oxygenation
congenital heart disease
cardiac surgery
pediatric
hypoplastic left heart syndrome
Note
学位審査副論文
Published Date
2012-05
Publication Title
Perfusion
Volume
volume27
Issue
issue3
Publisher
SAGE
Start Page
225
End Page
229
ISSN
0267-6591
NCID
AA10674287
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
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author
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DOI
Web of Science KeyUT
Related Url
https://doi.org/10.1177/0267659111434857
http://ousar.lib.okayama-u.ac.jp/54282