Extracorporeal membrane oxygenation and cyanotic congenital heart disease

1992 ◽  
Vol 2 (4) ◽  
pp. 359-360 ◽  
Author(s):  
Gale A. Pearson ◽  
Richard K. Firmin ◽  
Ranjit Leanage

AbstractWorldwide figures suggest that two percent of appropriate referrals for neonatal extracorporeal membrane oxygenation turn out to have previously covert congenital heart disease. This is despite the fact that expert cardiological evaluation is routine prior to cannulation. The experience in the United Kingdom includes such a case which is reported here. The implications for the role of pediatric cardiologists in such a service are considered.

2004 ◽  
Vol 78 (5) ◽  
pp. 1723-1727 ◽  
Author(s):  
Michiaki Imamura ◽  
Michael L. Schmitz ◽  
Bryan Watkins ◽  
Carl W. Chipman ◽  
Sherry C. Faulkner ◽  
...  

Author(s):  
Dash F. T. Newington ◽  
Fabrizio De Rita ◽  
Alan McCheyne ◽  
Claire Louise Barker

Background Ventricular assist devices (VADs) are increasingly being implanted in children, yet there is little literature to guide anesthetic management for these procedures. Aims To describe the pediatric population presenting for VAD implantation and the anesthetic management these patients receive. To compare (a) children under and over 12 months of age and (b) children with and without congenital heart disease. Methods Retrospective review of patients aged 0 to 17 years who underwent VAD implantation at a single center between 2014 and 2019. Results Seventy-seven VADs were implanted in 68 patients (46 left VADs, 24 biventricular VADs, 6 right VADs, and 1 univentricular VAD). One procedure was abandoned. Preoperatively, 20 (26%) patients were supported with extracorporeal membrane oxygenation and 57 (73%) patients were ventilated. Intraoperative donor blood products were required in 74 (95%) cases. Postimplantation inotropic support was required in 66 (85%) cases overall and 46 (100%) patients receiving a left VAD. Infants under 12 months were more likely to require preoperative extracorporeal membrane oxygenation (42% vs 19%), have femoral venous access (54% vs 28%), receive an intraoperative vasoconstrictor (42% vs 24%), and have delayed sternal closure (63 vs 22%). Mortality was higher in patients under 12 months (25% vs 19%) and in patients with congenital heart disease (25% vs 20%). Conclusions Children undergoing VAD implantation require high levels of preoperative organ support, high-dose intraoperative inotropic support, and high-volume blood transfusion. Children under 12 months and those with congenital heart disease are particularly challenging for anesthesiologists and have worse overall outcomes.


1995 ◽  
Vol 5 (2) ◽  
pp. 202-203 ◽  
Author(s):  
R. John Madar ◽  
Tim J.D. Donaldson ◽  
Stewart Hunter

the use of prostaglandians in maintaining the patency of the arterial duct in congenital heart disease is well established. Intravenous1-3 and ora12–4 administration has been used, although for acute use intravenous and possibly intraosseous5 routes are favored. Both prostaglandin E1 (alprostadil—ProstinVR: Upjohn)1,4 and prostaglandin E2 (dinoprostone—Prostin E2: Upjohn)2,3 are used for this purpose, although only prostaglandin E1 is licensed for this indication in the United Kingdom. Prostaglandin E1 costs approximately 8 times more than prostaglandin E2 (£56.96 versus £7.43 per vial).


2008 ◽  
Vol 18 (8) ◽  
pp. 757-766 ◽  
Author(s):  
RANDALL P. FLICK ◽  
JURAJ SPRUNG ◽  
STEPHEN J. GLEICH ◽  
ROXANN D. BARNES ◽  
DAVID O. WARNER ◽  
...  

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