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. 2021 Nov 29:8:741260.
doi: 10.3389/fcvm.2021.741260. eCollection 2021.

Pediatric Acute Myocarditis With Short-Term Outcomes and Factors for Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Cohort Study in Vietnam

Ta Anh Tuan  1   2   3 , Tran Dang Xoay  1 , Phan Huu Phuc  1 , Dau Viet Hung  1   2 , Nguyen Trong Dung  1 , Nguyen Ly Thinh Truong  4 , Nguyen Van Thuan  5 , Tran Minh Dien  2   5
Affiliations

Pediatric Acute Myocarditis With Short-Term Outcomes and Factors for Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Cohort Study in Vietnam

Ta Anh Tuan et al. Front Cardiovasc Med. .

Abstract

Objective: Data on the management and outcomes of acute myocarditis treated with extracorporeal membrane oxygenation (ECMO) among low- and middle-income countries are limited. This study aimed to determine the short-term outcomes and also identify factors associated with ECMO use among children with acute myocarditis at a tertiary children's hospital in Vietnam. Methods: A single-center, retrospective observational study was conducted between January 2016 and February 2021. Pediatric patients with acute myocarditis, aged 1 month to 16 years, were included. Results: In total, 54 patients (male, 46%; median age, 7 years) with acute myocarditis were included; 37 of them received ECMO support. Thirty percent (16/54) of the patients died, and 12 of them received ECMO. Laboratory variables that differed between survivors and non-survivors included median left ventricular ejection fraction (LVEF) at 48 h (42 vs. 25%; p = 0.001), platelet count (304 g/L [interquartile range (IQR): 243-271] vs. 219 g/L [IQR: 167-297]; p = 0.014), and protein (60 g/dl [IQR: 54-69] vs. 55 [IQR: 50-58]; p = 0.025). Among patients who received ECMO, compared with the survivors, non-survivors had a low LVEF at 48 h (odds ratio (OR), 0.8; 95% confidence interval (CI): 0.6-0.9; p = 0.006) and high vasoactive-inotropic score (OR, 1.0; 95% CI: 1.0-1.0; p = 0.038) and lactate (OR, 2.8; 95% CI, 1.2-6.1; p = 0.013) at 24 h post-ECMO. Conclusions: The case fatality rate among children with acute myocarditis was 30 and 32% among patients requiring ECMO support. Arrhythmia was an indicator for ECMO in patients with cardiogenic shock.

Keywords: acute myocarditis; cardiac arrhythmia; extracorporeal membrane oxygenation; mortality; pediatrics.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of enrolled cases. ECMO, extracorporeal membrane oxygenation.
See this image and copyright information in PMC

References

    1. Foerster SR, Canter CE, Cinar A, Sleeper LA, Webber SA, Pahl E, et al. . Ventricular remodeling and survival are more favorable for myocarditis than for idiopathic dilated cardiomyopathy in childhood: an outcomes study from the Pediatric Cardiomyopathy Registry. Circ Heart Fail. (2010) 3:689–97. 10.1161/CIRCHEARTFAILURE.109.902833 - DOI - PubMed
    1. Ghelani SJ, Spaeder MC, Pastor W, Spurney CF, Klugman D. Demographics, trends, and outcomes in pediatric acute myocarditis in the United States, 2006-2011. Circ Cardiovasc Qual Outcomes. (2012) 5:622–27. 10.1161/CIRCOUTCOMES.112.965749 - DOI - PubMed
    1. Duncan BW, Bohn DJ, Atz AM, French JW, Laussen PC, Wessel DL. Mechanical circulatory support for the treatment of children with acute fulminant myocarditis. J Thorac Cardiovasc Surg. (2001) 122:440–8. 10.1067/mtc.2001.115243 - DOI - PubMed
    1. Rajagopal SK, Almond CS, Laussen PC, Rycus PT, Wypij D, Thiagarajan RR. Extracorporeal membrane oxygenation for the support of infants, children, and young adults with acute myocarditis: a review of the Extracorporeal Life Support Organization registry. Crit Care Med. (2010) 38:382–7. 10.1097/CCM.0b013e3181bc8293 - DOI - PMC - PubMed
    1. Wu HP, Lin MJ, Yang WC, Wu KH, Chen CY. Predictors of extracorporeal membrane oxygenation support for children with acute myocarditis. Biomed Res Int. (2017) 2017:2510695. 10.1155/2017/2510695 - DOI - PMC - PubMed