Extended survival and re-hospitalisation among paediatric patients requiring extracorporeal membrane oxygenation for primary cardiac dysfunction

Cardiol Young. 2013 Apr;23(2):258-64. doi: 10.1017/S1047951112000777. Epub 2012 Jun 14.

Abstract

Background: Although survival to hospital discharge among children requiring extracorporeal membrane oxygenation support for medical and surgical cardio-circulatory failure has been reported in international registries, extended survival and re-hospitalisation rates have not been well described in the literature.

Material and methods: This is a single-institution, retrospective review of all paediatric patients receiving extracorporeal membrane oxygenation for primary cardiac dysfunction over a 5-year period.

Results: A total of 74 extracorporeal membrane oxygenation runs in 68 patients were identified, with a median follow-up of 5.4 years from hospital discharge. Overall, 66% of patients were decannulated alive and 25 patients (37%) survived to discharge. There were three late deaths at 5 months, 20 months, and 6.8 years from discharge. Of the hospital survivors, 88% required re-hospitalisation, with 63% of re-admissions for cardiac indications. The median number of hospitalisations per patient per year was 0.62, with the first re-admission occurring at a mean time of 9 months after discharge from the index hospitalisation. In all, 38% of patients required further cardiac surgery.

Conclusions: Extended survival rates for paediatric hospital survivors of cardiac extracorporeal membrane oxygenation support for medical and post-surgical indications are encouraging. However, re-hospitalisation within the first year following hospital discharge is common, and many patients require further cardiac surgery. Although re-admission hospital mortality is low, longer-term follow-up of quality-of-life indicators is required

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Extracorporeal Membrane Oxygenation*
  • Female
  • Follow-Up Studies
  • Heart Failure / mortality*
  • Heart Failure / therapy
  • Hospital Mortality
  • Humans
  • Infant
  • Infant, Newborn
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Multiple Organ Failure / mortality
  • Patient Readmission / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Survival Rate
  • Time Factors