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Cited by 107Mechanical Circulatory Support DevicesCongenital Heart Disease StudiesCardiac Arrest and Resuscitation

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Two–year survival, mental, and motor outcomes after cardiac extracorporeal life support at less than five years of age

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Lequier, Laurance, Joffe, Ari R., Robertson, Charlene M.T., Dinu, Irina A., Wongswadiwat, Yuttapong, Anton, Natalie R., Ross, David B., Rebeyka, Ivan M.·2008·The Journal of Thoracic and Cardiovascular Surgery
DOI 10.1016/j.jtcvs.2008.02.009
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Abstract

Objective Comprehensive outcome assessment of children receiving cardiac extracorporeal life support. Methods From 2000 to 2004, 39 consecutive children (aged 1 day to 4.4 years) had cardiac extracorporeal life support. Neurodevelopmental follow-up of all survivors was performed more than 6 months after life support (aged 53 +/- 12 months). Developmental delay was defined as a score of less than 70 on the Bayley Scales of Infant Development II or Wechsler Preschool and Primary Scale of Intelligence. Predictor variables for mortality (at 2 years' follow-up) and delay were examined by univariate and multivariate analyses. Results Indications for extracorporeal life support were progressive low cardiac output in 14 (36%), failed weaning from cardiopulmonary bypass in 13 (33%), cardiac arrest in 9 (23%), and hypoxia in 3 (8%). Cardiac anatomy was single ventricle in 16 (41%), biventricular in 21 (54%), and myocarditis in 2 (5%). Survival was 18 (46%) at hospital discharge and 16 (41%) at 2 years. In survivors, mental score was 73 +/- 16 (normal 100 +/- 15), and 8 (50%) had mental delay. Initiating extracorporeal life support during cardiopulmonary resuscitation and duration of this resuscitation were not associated with death or mental delay. On multivariable Cox regression, lactate on admission to the pediatric intensive care unit (hazard rate 1.13; 95% confidence intervals 1.08-1.27) and single ventricle anatomy (hazard rate 3.93; 95% confidence intervals 1.62-9.49) were associated with death at 2 years. Stepwise multiple regression found time for lactate to normalize on extracorporeal life support, highest inotrope score during 120 hours of life support, and chromosomal abnormality explained 76.7% of the variance in mental score. Conclusion Cardiac extracorporeal life support had a 41% 2-year survival. Potentially modifiable variables (time for lactate to normalize and highest inotrope score early during extracorporeal life support) explained 69% of mental score variance.

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  • Progressive low cardiac output syndrome is the cause for 36% of post-operative extracorporeal life support cannulations, making it one of the most common indications for extracorporeal life support in the post-operative period.

    “Progressive LCOS is the cause for 36% of post-operative ECLS cannulations, making it one of the most common indications for ECLS in the post-operative period [28-32].”

    From Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease (2016) · cites this paper as [28]

  • Survival of pediatric patients who receive extracorporeal life support after cardiac surgery is approximately 41-49%.

    “Survival of pediatric patients who receive ECLS after cardiac surgery is approximately 41-49% [28-32].”

    From Management of the Low Cardiac Output Syndrome Following Surgery for Congenital Heart Disease (2016) · cites this paper as [28]

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Research works printed but not linked: 28

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Metadata

Authors
Lequier, L., Joffe, A. R., Robertson, C. M. T., Dinu, I. A., Wongswadiwat, Y., Anton, N. R., Ross, D. B., & Rebeyka, I. M.
Affiliations
  • University of Alberta (CA)
  • Khon Kaen University (TH)
Corresponding author
Joffe, Ari R.
ORCID
Venue
The Journal of Thoracic and Cardiovascular Surgery
Publisher
Elsevier BV
Published
2008-10
Volume
136
Issue
4
Pages
976-983.e3
ISSN
0022-5223 (ISSN-L)
DOI
10.1016/j.jtcvs.2008.02.009
OpenAlex
W2049803285
Cited by
107
References
0
Citations by year
2026: 3 · 2025: 3 · 2024: 4 · 2022: 6 · 2021: 4 · 2020: 2 · 2019: 6 · 2018: 7 · 2017: 7 · 2016: 10 · 2015: 4 · 2014: 6 · 2013: 6 · 2012: 5
FWCI
7.07
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Thoracic and Cardiovascular Surgery (publishedVersion)
  • PubMed (publishedVersion)
Funders
Glenrose Rehabilitation Hospital
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Mechanical Circulatory Support Devices
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Congenital Heart Disease Studies
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
Keywords
two-year survival, neurodevelopmental outcomes, motor outcome, inotrope requirement, single ventricle, cardiopulmonary bypass weaning, cardiac arrest, hypoxia, chromosomal abnormalities, mortality risk factors, low cardiac output, Bayley Scales of Infant Development II
MeSH terms
Age Factors, Analysis of Variance, Mental Disorders, Cardiopulmonary Bypass, Cause of Death, Developmental Disabilities, Child, Preschool, Female, Heart Arrest, Heart Defects, Congenital, Cardiac Surgical Procedures, Humans, Infant, Infant, Newborn, Life Support Care, Male, Palliative Care, Postoperative Complications, Regression Analysis, Retrospective Studies, Sensitivity and Specificity, Time Factors, Extracorporeal Membrane Oxygenation, Cohort Studies, Multivariate Analysis, Confidence Intervals, Proportional Hazards Models, Survival Analysis, Cardiopulmonary Resuscitation, Treatment Outcome, Motor Skills Disorders

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