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

Published online by Cambridge University Press:  14 June 2012

Nicole Erwin ,
Jeannie Zuk ,
Jon Kaufman ,
Zhaoxing Pan ,
Esther Carpenter ,
Max B. Mitchell  and
Eduardo M. da Cruz
Nicole Erwin
Affiliation:
School of Medicine, Anschutz Medical Campus, The University of Colorado, Colorado, United States of America
Jeannie Zuk
Affiliation:
Department of Anesthesiology, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, United States of America
Jon Kaufman
Affiliation:
Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, United States of America
Zhaoxing Pan
Affiliation:
The Research Institute, University of Colorado, Colorado, United States of America
Esther Carpenter
Affiliation:
Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, United States of America
Max B. Mitchell
Affiliation:
Pediatric Cardiac Surgery, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, United States of America
Eduardo M. da Cruz*
Affiliation:
Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, Aurora, Colorado, United States of America
*
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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Abstract

Background

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.

Keywords

Paediatric cardiac surgerymechanical assistanceoutcomesre-admissions
Type
Original Article
Information
Cardiology in the Young , Volume 23 , Issue 2 , April 2013 , pp. 258 - 264
Copyright
Copyright © Cambridge University Press 2012 

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