Journal article
Midterm survival of infants requiring postoperative extracorporeal membrane oxygenation after Norwood palliation
Pediatric cardiology, Vol.34(3), pp.570-575
03/2013
DOI: 10.1007/s00246-012-0499-x
PMID: 23007923
Abstract
This study reports the mid-term survival for neonates undergoing extracorporeal membrane oxygenation (ECMO) after Norwood palliation at a single center. Limited data exist on the mid-term survival of patients undergoing ECMO after Norwood palliation. We reviewed our ECMO experience from July 1994 to October 2008 and compared two groups: patients who required ECMO after Norwood palliation and patients who underwent Norwood palliation without ECMO. We analyzed 30-day survival, survival to hospital discharge, and survival to most recent follow-up. One hundred sixty patients underwent Norwood palliation for hypoplastic left heart syndrome (HLHS) and its variants. A total of 32 patients (20%) required postoperative ECMO. Using Kaplan-Meier analysis, the predicted survival rates for Norwood/non-ECMO patients to 30 days, 1 year, and 3 years after the procedure are 87.6% (CI 79.5-91.5%), 62.5% (CI 54.3-71.0%), and 59.9% (CI 50.8-67.8%), respectively. Survival to 30 days, 1 year, and 3 years after Norwood was significantly decreased in Norwood/ ECMO patients, with predicted survival rates of 50.0% (CI 31.9-65.7%), 24.6% (CI 11.4-40.4), and 13.2% (CI 3.9-28.3%), respectively (p < 0.0001). Risk factors for hospital mortality included nonelective or emergency placement onto ECMO, longer duration of ECMO support, and the development of acute renal failure while on ECMO. Of the original Norwood/ECMO hospital survivors, only half of these patients survived a mean of nearly 4 years. ECMO after Norwood palliation is associated with significant mortality. Our data suggest that neonates who require ECMO after Norwood palliation are prone to continued attrition once discharged from the hospital.
Details
- Title: Subtitle
- Midterm survival of infants requiring postoperative extracorporeal membrane oxygenation after Norwood palliation
- Creators
- Mark G Debrunner - Children's Hospital of PittsburghPrashob Porayette - Hospital for Sick ChildrenJohn P Breinholt IIIMark W Turrentine - Riley Hospital for ChildrenTimothy M Cordes - Riley Hospital for Children
- Resource Type
- Journal article
- Publication Details
- Pediatric cardiology, Vol.34(3), pp.570-575
- DOI
- 10.1007/s00246-012-0499-x
- PMID
- 23007923
- ISSN
- 0172-0643
- eISSN
- 1432-1971
- Language
- English
- Date published
- 03/2013
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Internal Medicine
- Record Identifier
- 9984353894702771
Metrics
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