The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 2 , Pages 330-336.e2 , August 2010

Extracorporeal membrane oxygenation in postcardiotomy patients: Factors influencing outcome

  • T.K. Susheel Kumar, MD

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • David Zurakowski, PhD

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • Heidi Dalton, MD

      Affiliations

    • Department of Critical Care, Children's National Medical Center, Washington, DC
    • ,
  • Sachin Talwar, MD

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • Ayana Allard-Picou

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • Lennart F. Duebener, MD

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • Pranava Sinha, MD

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • ,
  • Achintya Moulick, MD, MBA

      Affiliations

    • Department of Cardiovascular Surgery, Children's National Medical Center, Washington, DC
    • Corresponding Author InformationAddress for reprints: Achintya Moulick, MD, MBA, Chief Cardiothoracic Surgery, St. Christopher's Hospital for Children, 3601 A St, Philadelphia, PA 19134.

Received 14 August 2009 ,Revised 17 January 2010 ,Accepted 13 February 2010.

References 

  1. ECLS Registry Report. International summary, Jan 2009. Extracorporeal life support organization. Ann Arbor (MI).
  2. Aharon AS, Drinkwater DC, Churchwell KB, Quisling SV, Reddy VS, Taylor M, et al. Extracorporeal membrane oxygenation in children after repair of congenital cardiac lesions. Ann Thorac Surg. 2001;72:2095–2101
  3. Morris MC, Ittenbach RF, Godinez RI, Portnoy JD, Tabbutt S, Hanna BD, et al. Risk factors for mortality in 137 pediatric cardiac intensive care unit patients managed with extracorporeal membrane oxygenation. Crit Care Med. 2004;32:1061–1069
  4. Duncan BW, Hraska V, Jonas RA, Wessel DL, Del Nido PJ, Laussen PC, et al. Mechanical circulatory support in children with cardiac disease. J Thorac Cardiovasc Surg. 1999;117:529–542
  5. Balasubramanian SK, Tiruvoipati R, Amin M, Aabideen KK, Peek GJ, Sosnowski AW, et al. Factors influencing the outcome of paediatric cardiac surgical patients during extracorporeal circulatory support. J Cardiothorac Surg. 2007;2:4
  6. Kolovos NS, Bratton SL, Moler FW, Bove EL, Ohye RG, Bartlett RH, et al. Outcome of pediatric patients treated with extracorporeal life support after cardiac surgery. Ann Thorac Surg. 2003;76:1435–1441
  7. Baslaim G, Bashore J, Al-Malki F, Jamjoom A. Can the outcome of pediatric extracorporeal membrane oxygenation after cardiac surgery be predicted?. Ann Thorac Cardiovasc Surg. 2006;12:21–27
  8. Shah SA, Shankar V, Churchwell KB, Taylor MB, Scott BP, Bartilson R, et al. Clinical outcomes of 84 children with congenital heart disease managed with extracorporeal membrane oxygenation after cardiac surgery. ASAIO J. 2005;51:504–507
  9. Jaggers JJ, Forbess JM, Shah AS, Meliones JN, Kirshbom PM, Miller CE, et al. Extracorporeal membrane oxygenation for infant postcardiotomy support: significance of shunt management. Ann Thorac Surg. 2000;69:1476–1483
  10. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–481
  11. Katz MH. Multivariable analysis: a practical guide for clinicians. 2nd ed.. Cambridge (United Kingdom): Cambridge University Press; 2006;p. 96-136
  12. Vittinghoff E, McCulloch CE. Relaxing the rule of ten events per variable in logistic and Cox regression. Am J Epidemiol. 2007;165:710–718
  13. Harrell FE, Lee KL, Mark DB. Multivariate prognostic models: issues in developing models, evaluating assumptions and adequacy, and measuring and reducing errors. Stat Med. 1996;15:361–387
  14. Baffes TG, Fridman JL, Bicoff JP, Whitehill JL. Extracorporeal circulation for support of palliative cardiac surgery in infants. Ann Thorac Surg. 1970;10:354–363
  15. De Angeli S, Paccagnella A, Mordacchini M, Frugoni C, Zanardo G, Turolla L, et al. The effects of prolonged cardiopulmonary bypass on cell-mediated immunity. Thorac Cardiovasc Surg. 1994;42:14–20
  16. Markewitz A, Faist E, Lang S, Hültner L, Weinhold C, Reichart B. An imbalance in T-helper cell subsets alters immune response after cardiac surgery. Eur J Cardiothorac Surg. 1996;10:61–67
  17. Hadley JS, Wang JE, Michaels LC, Dempsey CM, Foster SJ, Thiemermann C, et al. Alterations in inflammatory capacity and TLR expression on monocytes and neutrophils after cardiopulmonary bypass. Shock. 2007;27:466–473
  18. Tanzi MC. Bioactive technologies for hemocompatibility. Expert Rev Med Dev. 2005;2:473–492
  19. Deptula J, Glogowski K, Merrigan K, Hanson K, Felix D, Hammel J, et al. Evaluation of biocompatible cardiopulmonary bypass circuit use during pediatric open heart surgery. J Extra Corpor Technol. 2006;38:22–26
  20. Wendel HP, Ziemer G. Coating-techniques to improve the hemocompatibility of artificial devices used for extracorporeal circulation. Eur J Cardiothorac Surg. 1999;16:342–350
  21. Valdés Xenia S. Risk of blood transfusion in cardiac surgery. Arch Cardiol Mex. 2006;76(Suppl. 2):S86–S91
  22. Lequier L, Joffe AR, Robertson CM, Dinu IA, Wongswadiwat Y, Anton NR, et al. Western Canadian Complex Pediatric Therapies Program Follow-up Group. Two-year survival, mental, and motor outcomes after cardiac extracorporeal life support at less than five years of age. J Thorac Cardiovasc Surg. 2008;136:976–983
  23. Montgomery VL, Strotman JM, Ross MP. Impact of multiple organ system dysfunction and nosocomial infections on survival of children treated with extracorporeal membrane oxygenation after heart surgery. Crit Care Med. 2000;28:526–531
  24. Székely A, Cserép Z, Sápi E, Breuer T, Nagy CA, Vargha P, et al. Risks and predictors of blood transfusion in pediatric patients undergoing open heart operations. Ann Thorac Surg. 2009;87:187–197
  25. Terry B, Gunst G, Melchior R, Wolfe D, Feocco N, Graham S, et al. A description of a prototype miniature extracorporeal membrane oxygenation circuit using current technologies in a sheep model. J Extra Corpor Technol. 2005;37:315–317

 Disclosures: None.

PII: S0022-5223(10)00217-5

doi: 10.1016/j.jtcvs.2010.02.034

The Journal of Thoracic and Cardiovascular Surgery
Volume 140, Issue 2 , Pages 330-336.e2 , August 2010

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