Extracorporeal membrane oxygenation support after pediatric cardiac surgery: Our single-center experience

Background: In this study, we present our five-year extracorporeal membrane oxygenation experiences in patients requiring mechanical support after pediatric open heart surgery. Methods: We retrospectively reviewed the medical records of 29 children (16 males, 13 females; mean age 21.6 months; range 5 days to 162 months) who underwent open heart surgery and required extracorporeal membrane oxygenation support due to postcardiotomy circulatory failure between February 2010 and March 2015. Results: The most common diagnosis was tetralogy of Fallot in eight patients (27.5%). The most common extracorporeal membrane oxygenation indication was failure to wean from cardiopulmonary bypass in 12 (41%) patients. The mean duration of extracorporeal membrane oxygenation support was 6.9 days (range 14 hours to 32 days). The most common complication related to extracorporeal membrane oxygenation support was renal insufficiency in 14 patients (48.3%). Fourteen patients (48%) were able to be successfully weaned from extracorporeal membrane oxygenation support, while six patients (20.7%) were discharged without any neurological sequelae. No significant predictor of mortality was found. Failure to wean from cardiopulmonary bypass resulted improved outcomes than other extracorporeal membrane oxygenation indications. Conclusion: Extracorporeal membrane oxygenation provides an effective cardiopulmonary support for cardiopulmonary failure after pediatric open heart surgery. Careful patient selection, and correct timing and appropriate management of extracorporeal membrane oxygenation are crucial for optimal outcomes.