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. 2021 Aug 30;51(4):1733-1737.
doi: 10.3906/sag-2002-10.

Pediatric extracorporeal cardiopulmonary resuscitation: single-center study

Tanıl Kendirli  1 , Serhan Özcan  1 , Merve Havan  1 , Çağdaş Baran  2 , Mehmet Çakıcı  2 , Burcu Arıcı  2 , Özlem Selvi Can  3 , Zeynep Eyileten  2 , Tayfun Uçar  4 , Ercan Tutar  4 , Ahmet Rüçhan Akar  2
Affiliations

Pediatric extracorporeal cardiopulmonary resuscitation: single-center study

Tanıl Kendirli et al. Turk J Med Sci. .

Abstract

Background/aim: Extracorporeal cardiopulmonary resuscitation (ECPR) is defined as the venoarterial extracorporeal membrane oxygenation (VA-ECMO) support in a patient who experienced a sudden pulseless condition attributable to cessation of cardiac mechanical activity and circulation. We aimed to evaluate the clinical outcomes of our ECPR experience in a pediatric patient population.

Materials and methods: Between September 2014 and November 2017, 15 children were supported with ECPR following in-hospital cardiac arrest (IHCA) in our hospitals. VA-ECMO setting was established for all patients. Pediatric cerebral performance category (PCPC) scales and long-term neurological prognosis of the survivors were assessed.

Results: The median age of the study population was 60 (4–156) months. The median weight was 18 (4.8–145) kg, height was 115 (63–172) cm, and body surface area was 0.73 (0.27–2.49) m2. The cause of cardiac arrest was a cardiac and circulatory failure in 12 patients (80%) and noncardiac causes in 20%. Dysrhythmia was present in 46%, septic shock in 13%, bleeding in 6%, low cardiac output syndrome in 13%, and airway disease in 6% of the study population. Median low-flow time was 95 (range 20–320) min. Central VA- ECMO cannulation was placed in only 2 (13.3%) cases. However, the return of spontaneous circulation (ROSC) was obtained in 10 (66.6%) patients, and 5 (50%) of them survived. Overall, 5 patients were discharged from the hospital. Finally, survival following ECPR was 33.3%, and all survivors were neurologically intact at hospital-discharge.

Conclusion: ECPR can be a life-saving therapeutic strategy using a promising technology in the pediatric IHCA population. Early initiation and a well-coordinated, skilled, and dedicated ECMO team are the mainstay for better survival rates.

Keywords: Extracorporeal cardiopulmonary resuscitation; extracorporeal membrane oxygenation; children.

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Conflict of interest statement

CONFLICT OF INTEREST:

The authors of this manuscript have no conflicts of interest to disclose, as described by the Turkish Journal of Medical Sciences.

Figures

Figure 1
Figure 1
CPR-ECPR duration diagram showing low-flow and total cardiac arrest times. ECPR, extracorporeal cardiopulmonary resuscitation; CA, cardiac arrest; CPR, cardiopulmonary resuscitation; VA-ECMO, venoarterial extracorporeal membrane oxygenation.
Figure 2
Figure 2
The causes of cardiac arrest. LCOS = low cardiac output syndrome.
See this image and copyright information in PMC

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