Características y desenlaces clínicos de pacientes menores de 18 años tratados con oxigenación con membrana extracorpórea posterior a cirugía para la reparación o paliación de cardiopatías congénitas
Iván A. Pinto-Martínez, Gustavo A. Cruz-Suárez, Walter Mosquera-Álvarez, V. Mejía-Quiñones, Daniela Burbano-Gálviz
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引用次数: 0
Abstract
Objective: to determine the characteristics and clinical outcomes of patients under 18 years of age treated with extracorporeal membrane oxygenation (ECMO) after surgery for the repair or palliation of congenital heart disease. Method: longitudinal descriptive study with retrospective data collection. Results: between January 2015 and December 2020, 77 patients required ECMO after pediatric cardiac surgery with a median age of < 1 month, median weight of 4 kg, ECC time 202 minutes (IQR 125-272 minutes), aortic cross-clamp time 95 minutes. 76.6% were supported with ECMO prior to their return to the ICU. The congenital heart disease most frequently admitted to ECMO was hypoplastic left heart syndrome (19.4%) in the Norwood postoperative period (18.1%). The median time of ECMO was 111 hours. The most frequent indication was ventricular dysfunction (80.5%). 80.5% presented complications and reoperation for bleeding was the most frequent of these (46.7%). ECMO survival was 48% and overall survival at discharge was 25.97%. Age < 1 month (p = 0.030), pre-ECMO lactic acid ≥ 5 mmol/l (p = 0.014), OR 0.260 and time of normalization of lactate ≥ 24 hours (0.021), OR 0.24 were asso - ciated with a higher risk of mortality at hospital discharge. Conclusions: ECMO provides adequate support after surgery for the repair or palliation of congenital heart disease. Age < 1-month, pre-ECMO lactic acid ≥ 5 mmol/l, and lactate normaliza - tion time ≥ 24 hours were the variables that were associated with poor outcome and hospital mortality.
期刊介绍:
The Colombian Cardiology Review is an official publication of the Colombian Cardiology and Cardiovascular Surgery Society, emitted bimonthly. Its uninterrupted circulation was initiated in 1985. The main objective of the review is the publication of the scientific, investigative, academic and administrative activities of the society members, of the medical professionals or of those connected with the health sector, nationals or foreigners, that may be working in the Cardiology field or related sciences.