Outcomes after prolonged extracorporeal membrane oxygenation support in children with cardiac disease—Extracorporeal Life Support Organization registry.

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Presentation transcript:

Outcomes after prolonged extracorporeal membrane oxygenation support in children with cardiac disease—Extracorporeal Life Support Organization registry study Eric Dean Merrill, BA, Laura Schoeneberg, MD, Pratik Sandesara, MD, Erica Molitor-Kirsch, MD, James O'Brien, MD, Hongying Dai, PhD, Geetha Raghuveer, MD The Journal of Thoracic and Cardiovascular Surgery Volume 148, Issue 2, Pages 582-588 (August 2014) DOI: 10.1016/j.jtcvs.2013.09.038 Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Total number of prolonged cardiac and cardiac extracorporeal membrane oxygenation (ECMO) runs from January 1, 2000 to December 31, 2011. Listed in parentheses are the number of centers that reported to the Extracorporeal Life Support Organization each year. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 582-588DOI: (10.1016/j.jtcvs.2013.09.038) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Survival stratified by extracorporeal membrane oxygenation (ECMO) duration. Children receiving prolonged cardiac ECMO support were divided into 3 groups according to the duration: 14 to 20.9, 21 to 27.9, and ≥28 days. Dashed line represents the survival for overall cardiac ECMO (45%). A significant decrease was seen in survival in all 3 prolonged ECMO duration subgroups compared with the overall cardiac ECMO survival (P < .01). Survival decreased further to 13% after 28 days of ECMO support (P < .01). The Journal of Thoracic and Cardiovascular Surgery 2014 148, 582-588DOI: (10.1016/j.jtcvs.2013.09.038) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Survival stratified by diagnosis over time. The number of children surviving with extracorporeal membrane oxygenation (ECMO) support over time within the 4 major diagnoses: myocarditis, cardiomyopathy, and congenital heart disease (2-ventricle and 1-ventricle physiology). A diagnosis of congenital heart disease, especially 1-ventricle physiology, was a predictor of poor survival. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 582-588DOI: (10.1016/j.jtcvs.2013.09.038) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 Competing outcomes analysis showing outcomes as follows: children who died without receiving cardiac transplantation, children who survived to hospital discharge without receiving cardiac transplantation, children who survived to discharge after receiving cardiac transplantation, and children who died after cardiac transplantation. As the duration of prolonged ECMO increased, the most prominent outcome was death without undergoing transplantation. The transplanted population constituted only a small percentage of the cohort. ECMO, Extracorporeal membrane oxygenation. The Journal of Thoracic and Cardiovascular Surgery 2014 148, 582-588DOI: (10.1016/j.jtcvs.2013.09.038) Copyright © 2014 The American Association for Thoracic Surgery Terms and Conditions