PMID- 30834480
OWN - NLM
STAT- MEDLINE
DCOM- 20191224
LR  - 20200225
IS  - 1432-1076 (Electronic)
IS  - 0340-6199 (Linking)
VI  - 178
IP  - 6
DP  - 2019 Jun
TI  - Outcomes following venoarterial extracorporeal membrane oxygenation in children 
      with refractory cardiogenic disease.
PG  - 783-793
LID - 10.1007/s00431-019-03352-5 [doi]
AB  - Retrospective analysis was performed at an affiliated university children's 
      hospital with consecutive patients receiving a venoarterial extracorporeal 
      membrane oxygenation (VA-ECMO) for refractory cardiogenic shock from July 2007 to 
      May 2018. Fifty-six patients underwent VA-ECMO for refractory cardiogenic shock 
      with the median age of 39.0 (1.5, 103.5) months were included. Median ECMO 
      duration was 87 h, and the median length of hospital stay was 22 days. Successful 
      ECMO weaning rate was 68%. Thirty-day mortality in this cohort was 39% (22/56), 
      among which the mortality of fulminant myocarditis and postcardiotomy cardiogenic 
      shock (PCS) were 23% (6/26) and 52% (12/23), respectively. Multivariate Cox 
      proportional hazard regression analysis identified prolonged prothrombin time 
      (PT) > 6 s and elevated lactate level 24 h after ECMO initiation were associated 
      with 30-day mortality.Conclusions: Pediatric VA-ECMO for refractory cardiogenic 
      shock appears to be a satisfactory salvage therapy to various fatal diseases in 
      this retrospective study. Prolonged PT > 6 s and elevated lactate level 24 h were 
      significant predictors of 30-day mortality. What is Known: * VA-ECMO is a salvage 
      therapy for refractory cardiogenic shock in pediatrics. What is New: * 
      Prothrombin time > 6 s was a significant predictor of 30-day mortality. * 
      Elevated lactate level 24 h was a significant predictor of 30-day mortality.
FAU - Yang, Lijun
AU  - Yang L
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - Ye, Lifen
AU  - Ye L
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - Fan, Yong
AU  - Fan Y
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - He, Wenlong
AU  - He W
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - Zong, Qing
AU  - Zong Q
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - Zhao, Wenting
AU  - Zhao W
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China.
FAU - Lin, Ru
AU  - Lin R
AUID- ORCID: 0000-0001-8319-4995
AD  - Department of Extracorporeal Circulation and Extracorporeal Life Support, Heart 
      Institute, Zhejiang University School of Medicine Children's Hospital, 3333 
      Binsheng Road, Binjiang District, Hangzhou, 310052, Zhejiang, China. 
      linru.008@163.com.
LA  - eng
GR  - LGF18H020005/Science and Technology Planning Project of Zhejiang Province/
PT  - Journal Article
DEP - 20190304
PL  - Germany
TA  - Eur J Pediatr
JT  - European journal of pediatrics
JID - 7603873
RN  - 33X04XA5AT (Lactic Acid)
RN  - 9001-26-7 (Prothrombin)
SB  - IM
MH  - Child
MH  - Child, Preschool
MH  - Extracorporeal Membrane Oxygenation/methods/*mortality
MH  - Female
MH  - Heart Defects, Congenital/surgery
MH  - *Hospital Mortality
MH  - Humans
MH  - Infant
MH  - Lactic Acid/blood
MH  - Length of Stay
MH  - Male
MH  - Myocarditis/mortality/therapy
MH  - Postoperative Complications/*mortality/therapy
MH  - Proportional Hazards Models
MH  - Prothrombin/metabolism
MH  - Retrospective Studies
MH  - Salvage Therapy/methods/mortality
MH  - Shock, Cardiogenic/*mortality/therapy
MH  - Time Factors
OTO - NOTNLM
OT  - Mortality
OT  - Pediatric
OT  - Refractory cardiogenic shock
OT  - Venoarterial extracorporeal membrane oxygenation
EDAT- 2019/03/06 06:00
MHDA- 2019/12/25 06:00
CRDT- 2019/03/06 06:00
PHST- 2018/12/16 00:00 [received]
PHST- 2019/02/19 00:00 [accepted]
PHST- 2019/02/12 00:00 [revised]
PHST- 2019/03/06 06:00 [pubmed]
PHST- 2019/12/25 06:00 [medline]
PHST- 2019/03/06 06:00 [entrez]
AID - 10.1007/s00431-019-03352-5 [pii]
AID - 10.1007/s00431-019-03352-5 [doi]
PST - ppublish
SO  - Eur J Pediatr. 2019 Jun;178(6):783-793. doi: 10.1007/s00431-019-03352-5. Epub 
      2019 Mar 4.