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Extracorporeal membrane oxygenation as a bridge to cardiac transplantation in children.

Abstract
The feasibility and efficacy of extracorporeal membrane oxygenation (ECMO) as a bridge to cardiac transplantation was examined in 6 pediatric patients who suffered irreversible myocardial failure after undergoing surgery for congenital heart defects. The mean time of ECMO support was 260.5 h, range 101-402 h. Three patients underwent transplantation, 2 of whom are long-term survivors. Progressive hypotension as a result of capillary leak syndrome precluded further ECMO support in the other 3 patients. Overall, 2 of the 6 patients survived. Major complications were encountered in 4 patients including bleeding in 2, a seizure in 1, and renal failure in 3, 2 of whom recovered renal function after transplantation. Infection did not occur in any of the 6 patients. Exchanging ECMO components was performed with no difficulties; these exchanges included a centrifugal pump once for 3 patients and a membrane oxygenator once for 2 patients. Our results indicate that ECMO can safely keep critically ill pediatric transplant candidates alive for more than 1 week with a low incidence of multiple organ failure.
AuthorsK Ishino, Y Weng, V Alexi-Meskishvili, M Loebe, F Uhlemann, P E Lange, R Hetzer
JournalArtificial organs (Artif Organs) Vol. 20 Issue 6 Pg. 728-32 (Jun 1996) ISSN: 0160-564X [Print] United States
PMID8817988 (Publication Type: Clinical Trial, Journal Article)
Topics
  • Adolescent
  • Child, Preschool
  • Extracorporeal Membrane Oxygenation (standards)
  • Female
  • Heart Defects, Congenital (surgery)
  • Heart Failure (surgery)
  • Heart Transplantation (trends)
  • Humans
  • Infant
  • Male
  • Postoperative Complications (mortality)
  • Treatment Outcome

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