ECMO in paediatric cardiac surgery: 5-year single centre experience

Abstract

Abstract Background. Extracorporeal membrane oxygenation (ECMO) has become an integral part of paediatric cardiac surgery. We report the experience of a well-established ECMO service over a 5-year period. Methods. This retrospective study analysed all paediatric patients who required ECMO support following cardiac surgery from April 2015 to March 2020. Inclusion criteria were age less than 18 and post-operative ECMO support. Patients were analysed dividing into groups according to the urgency for ECMO support (extracorporeal cardiopulmonary resuscitation (ECPR) and cardiac ECMO) and according to age (neonatal and paediatric ECMO groups). They were followed for 30-day, 6-month mortality, long-term survival, postoperative morbidity and the need for reintervention. Results. 46 patients were included who had a total of 48 ECMO runs. The 5-year incidence of the need for ECMO after cardiac surgery was 3.3% (48 of the overall 1441 cases recorded). 30-day, 6-month and follow-up survival rate was 85%, 65% and 52% respectively. At the 6-month follow-up, the ECPR group showed a trend towards worse survival compare with the cardiac ECMO group (47% vs 55%) but with no statistical significance (p = 0.35). Furthermore, the survival rates between paediatric (60%) and neonatal (46%) ECMO groups were similar, with no statistical significance (p = 0.45). The rate of acute neurological events was 27% (13/48). Conclusion. ECPR and neonatal ECMO groups had higher mortality. ECMO 30-day and 6-month survival rates were better compared with other studies 85% and 65% respectively. Incidence of ECMO and neurological complication rates were in line with other high-volume centres.