Extracorporeal membrane oxygenation for perioperative cardiac support in children I: experience at the Deutsches Herzzentrum Berlin (1987-2005)

Abstract

We report our experience in pediatric patients supported by extracorporeal membrane oxygenation (ECMO) for perioperative circulatory failure from January 1987 to June 2005. Pediatric patients (n = 110) who had ECMO support for congenital heart defects, myocarditis, and cardiomyopathy (age range, newborn to 18 years; weight range, 2.3-69 kg) were included and divided into three groups based on timing of ECMO support. EMCO support was used preoperatively in 21 patients (19.1%) (mean age, 4 years +/- 8 months; mean weight, 23.7 +/- 8.9 kg). Duration of ECMO support was 8.3 +/- 7 days. Fifty-six patients (56.56%) (mean age, 5.11 +/- 5 years; mean weight, 15.7 +/- 6.9 kg) had intraoperative ECMO support for myocardial insufficiency, low output syndrome, right ventricular failure, left ventricular failure, malignant arrhythmia, pulmonary hypertension, and repeated resuscitation. Mean duration of ECMO support was 4.98 +/- 1 days. Postoperative ECMO support was used in 29 patients (mean age, 7.5 +/- 1 years; mean weight, 23.4 +/- 6.4 kg). Mean duration of ECMO was 4.6 +/- 1 days. Mean postoperative day of ECMO institution was 40.4 +/- 2 days. Our experience shows that ECMO support can be offered perioperatively to any patient with potentially reversible pulmonary, cardiac, or cardiopulmonary failure, excluding those whose outcome is inevitable.