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. 2014 Dec 31;2(1):68.
doi: 10.1186/s40560-014-0068-x. eCollection 2014.

Current experience and limitations of extracorporeal cardiopulmonary resuscitation for cardiac arrest in children: a single-center retrospective study

Kohei Tsukahara  1 , Chiaki Toida  2 , Takashi Muguruma  2
Affiliations

Current experience and limitations of extracorporeal cardiopulmonary resuscitation for cardiac arrest in children: a single-center retrospective study

Kohei Tsukahara et al. J Intensive Care. .

Abstract

Background: There are few reports detailing the importance of extracorporeal membrane oxygenation (ECMO) for pediatric cardiac arrest in Japan. We investigated the status and issues surrounding extracorporeal cardiopulmonary resuscitation (ECPR) at our institution.

Methods: Patients aged <15 years who underwent ECPR between April 1, 2003 and March 31, 2012 were eligible. The characteristics, cannulation site, durations of cardiopulmonary resuscitation (CPR), cannulation procedure, and ECMO, and neurologic outcomes were retrospectively reviewed. A favorable neurologic outcome was defined as Pediatric Cerebral Performance Categories 1 and 2.

Results: A total of 21 ECPR events were identified. The median CPR and cannulation durations were 60 and 25 min, respectively. Central and peripheral access sites were employed in 15 and six cases, respectively. Five of the 21 patients (24%) were successfully weaned from ECMO and three of the 21 (14%) survived. Two of the three survivors had a favorable neurologic outcome.

Conclusions: The mortality of patients undergoing ECPR at our institution was low. However, about 10% of all patients had a favorable neurologic outcome, which suggests that ECPR may be effective in pediatric cardiac arrest patients.

Keywords: Cardiac arrest; Extracorporeal cardiopulmonary resuscitation; Extracorporeal membrane oxygenation; Pediatric intensive care.

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Figures

Figure 1
Figure 1
Comparison of CPR duration before and after the introduction of the flowchart for ECPR. The median CPR duration decreased from 86 min during 2003–2008 to 38 min during 2009–2011. The flowchart for ECMO was introduced at our facility in 2009. ECMO, extracorporeal membrane oxygenation.
Figure 2
Figure 2
Comparison of ECMO procedure during according to the cannulation site. The procedure duration was shorter for ECMO cannulation using a thoracic approach than the procedures performed at the neck and femur. ECMO, extracorporeal membrane oxygenation. The chest site is indicated by the circles, the neck indicated by triangles, and the femur indicated by squares.
See this image and copyright information in PMC

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