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Extended survival and re-hospitalisation among paediatric patients requiring extracorporeal membrane oxygenation for primary cardiac dysfunction

  • Nicole Erwin (a1), Jeannie Zuk (a2), Jon Kaufman (a3), Zhaoxing Pan (a4), Esther Carpenter (a5), Max B. Mitchell (a6) and Eduardo M. da Cruz (a7)...
Abstract
AbstractBackground

Although survival to hospital discharge among children requiring extracorporeal membrane oxygenation support for medical and surgical cardio-circulatory failure has been reported in international registries, extended survival and re-hospitalisation rates have not been well described in the literature.

Material and methods

This is a single-institution, retrospective review of all paediatric patients receiving extracorporeal membrane oxygenation for primary cardiac dysfunction over a 5-year period.

Results

A total of 74 extracorporeal membrane oxygenation runs in 68 patients were identified, with a median follow-up of 5.4 years from hospital discharge. Overall, 66% of patients were decannulated alive and 25 patients (37%) survived to discharge. There were three late deaths at 5 months, 20 months, and 6.8 years from discharge. Of the hospital survivors, 88% required re-hospitalisation, with 63% of re-admissions for cardiac indications. The median number of hospitalisations per patient per year was 0.62, with the first re-admission occurring at a mean time of 9 months after discharge from the index hospitalisation. In all, 38% of patients required further cardiac surgery.

Conclusions

Extended survival rates for paediatric hospital survivors of cardiac extracorporeal membrane oxygenation support for medical and post-surgical indications are encouraging. However, re-hospitalisation within the first year following hospital discharge is common, and many patients require further cardiac surgery. Although re-admission hospital mortality is low, longer-term follow-up of quality-of-life indicators is required.

Copyright
Corresponding author
Correspondence to: Dr E. M. da Cruz, MD, Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, School of Medicine, University of Colorado at Denver, 13120 East 16th Avenue, B-100, Aurora, Colorado 80045, United States of America. Tel: +1 720 777 4055; Fax: +1 720 777 7290; E-mail: eduardo.dacruz@childrenscolorado.org
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Cardiology in the Young
  • ISSN: 1047-9511
  • EISSN: 1467-1107
  • URL: /core/journals/cardiology-in-the-young
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