Extracorporeal life support in cyanotic congenital heart disease before cardiovascular operation.

Details

Serval ID
serval:BIB_32E48E7CC3FD
Type
Article: article from journal or magazin.
Collection
Publications
Title
Extracorporeal life support in cyanotic congenital heart disease before cardiovascular operation.
Journal
American Journal of Cardiology
Author(s)
Hunkeler N.M., Canter C.E., Donze A., Spray T.L.
ISSN
0002-9149 (Print)
ISSN-L
0002-9149
Publication state
Published
Issued date
1992
Peer-reviewed
Oui
Volume
69
Number
8
Pages
790-793
Language
english
Notes
Publication types: Journal ArticlePublication Status: ppublish
Abstract
From July 1988 to March 1991, extracorporeal membrane oxygenation (ECMO) was used in 8 infants (newborn to 16 months old) with unoperated cyanotic congenital heart disease and cardiopulmonary collapse, associated with hypercyanotic spells (4 infants), pulmonary hypertensive crises (3) and sepsis (1). Indications for ECMO support were arterial saturations less than or equal to 60% accompanied by hypotension and metabolic acidosis unresponsive to mechanical ventilation with 100% oxygen, paralysis and sedation, and pharmacologic support with inotropes or vasodilators, or both. Venoarterial bypass by carotid/jugular cannulation with flow rates of 100 to 840 ml/kg/min (mean 460) stabilized all patients. Duration of ECMO support ranged from 15 to 840 hours and was associated with transient seizures (1 patient) and renal failure (1). Seven patients underwent palliative (3 patients) or corrective (4) surgical procedures while on ECMO or within 48 hours of decannulation, including 1 patient bridged to double-lung transplantation with a long (840 hours) duration of ECMO. There was 1 operative and 2 late (greater than 1 month after decannulation) deaths, for an overall survival rate of 62%. These 5 survivors all have normal growth and development, and patent neck vessels at the site of cannulation. These early results indicate that ECMO can be effective mechanical support in cardiovascular crises untreatable with maximal conventional medical therapy and can be used as a bridge to successful surgical palliation or repair.
Keywords
Cohort Studies, Extracorporeal Membrane Oxygenation/adverse effects, Heart Defects, Congenital/physiopathology, Heart Defects, Congenital/therapy, Humans, Infant, Infant, Newborn, Pulmonary Circulation, Survival Analysis, Treatment Outcome, Vascular Resistance
Pubmed
Web of science
Create date
03/08/2014 14:14
Last modification date
20/08/2019 13:18
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