Skip to main content

Table 2 Description of the patients who had early post-operative ECMO by E-CPR or non-E-CPR indication

From: Predictors and outcomes of early post-operative veno-arterial extracorporeal membrane oxygenation following infant cardiac surgery

Variable E-CPR
n = 10 		Non-E-CPR
n = 10 		p value
Demographic variables
 Sex (male) 6(60%) 7(70%) 1.000
 Birth gestation (weeks) 38.0 (1.9) 38.8 (1.3) 0.519
 Birth weight (grams) 3141.4 (596.7) 3190.5(334.5) 0.823
Cardiac defecta
 RACHS-1 score 6 [4, 6] 4 [4, 6]  
 HLHS 3 (30%) 3 (30%)  
 HLHS variant 3 (30%) 1 (10%)  
 TAPVD 1 (10%) 1 (10%)  
 Pulmonary atresia 0 (0%) 1 (10%)  
 Tricuspid atresia (1 with hypoplastic arch) 2 (20%) 0 (0%)  
 D-TGA 1 (10%) 2 (20%)  
 Other 0 (0%) 2 (20%)  
 Year of admission 2009(3.6) 2008(3.2) 0.519
 Age (days) at time of ECMO 13.5(10.0) 11.9(6.8) 0.679
 Chromosomal abnormality 0 (0%) 2 (20%) 0.474
Operating room variables
 Cardiopulmonary bypass time (minutes) n = 10 n = 9 0.837
145.5(84.6) 137.6(80.6)
 Aortic cross-clamp time (minutes), n = 18 n = 10 n = 8 0.756
65.0(48.8) 72.0(43.6)  
 Deep hypothermic circulatory arrest time (minutes), n = 15 n = 8 n = 7 0.867
24.4(19.0) 25.9(13.7)
 Highest vasoactive-inotrope score 24.9(17.4) 48.0(50.4) 0.199
 Highest vasoactive-inotrope score > 30 2(20%) 4(40%) 0.628
 Highest epinephrine dose (for > 30 min; μg/kg/min) 0.15(0.13) 0.37(0.50) 0.214
 Highest epinephrine dose > 0.3 μg/kg/min 1(10%) 2(20%) 1.000
 Highest norepinephrine dose (for > 30 min; μg/kg/min) 0.03(0.07) 0.04(0.10) 0.749
 Highest dobutamine dose (μg/kg/min) 0.5(1.6) 1.0(3.2) 0.660
 Highest dopamine dose (μg/kg/min) 1.9(3.0) 3.7(4.2) 0.277
 Highest milrinone dose (μg/kg/min) 0.48(0.28) 1.0(2.3) 0.427
 Highest lactate once off CPB 7.1(2.3) 6.3(3.5) 0.541
 Lowest pH once off CPB 7.29(0.05) 7.27(0.11) 0.555
 Calcium bolus given 9(90%) 8(80%) 1.000
 Steroids given 9(90%) 8(80%) 1.000
 Open sternum from operating room 8(80%) 9(90%) 1.000
 Need to re-institute CPB n = 10 n = 9 0.303
3(30%) 1(11%)
Post-operative day 1 variables
 PRISM III score 21.1 (6.5) 19.5 (6.5) 0.588
 Time to ECMO after admission to PCICU (hours) 11.2(8.5) 13.7(14.2) 0.631
 Highest lactate (mmol/L) 8.6(4.7) 7.7(5.1) 0.712
 Highest lactate > 6 mmol/L 7(70%) 5(50%) 0.650
 Lowest pH 7.28(0.05) 7.25(0.09) 0.343
 Lowest base deficit − 5.7(3.1) − 4.4(4.1) 0.418
 Lowest PaO2 (mmHg) 46.5(20.5) 54.6(47.2) 0.624
 Highest creatinine (μmol/L) 61.3(25.4) 65.4(31.7) 0.753
 Open sternum at any point on day 1 9(90%) 10(100%) 1.000
 Highest vasoactive-inotrope score 18.4(8.8) 55.6(43.3) 0.024
 Highest vasoactive-inotrope score > 30 0(0%) 7(70%) 0.003
 Highest epinephrine dose (μg/kg/min) 0.10(0.06) 0.32(0.33) 0.060
 Highest epinephrine dose > 0.3 μg/kg/min 0(0%) 3(30%) 0.211
 Highest norepinephrine dose (μg/kg/min) 0.006(0.019) 0.06(0.10) 0.103
 Highest dobutamine dose (μg/kg/min) 0 0.8(2.5) 0.343
 Highest dopamine dose (μg/kg/min) 2.3(4.2) 3.2(4.9) 0.685
 Highest milrinone dose (μg/kg/min) 0.50(0.36) 0.35(0.32) 0.326
Indication for ECMO
 Cardiac tamponade – 2(20%)  
 Low cardiac output syndrome – 10(100%)  
 Hypoxia – 1(10%)  
 Dysrhythmia – 0(0%)  
 Cardiopulmonary resuscitation done (excluding E-CPR) 0(0%) 2(20%) 0.474
 Cardiopulmonary resuscitation time (including E-CPR; minutes) 33(6) n = 2 0.797
9(7)
 Other peri-operative period variables
 Transesophageal echocardiogram done in PCICU 6(60%) 10(100%) 0.087
 Cardiac catheterization performed post-operatively 5(50%) 4(40%) 1.000
 Residual defect found: requiring return to operating room or catheterization laboratory 3(30%) 5(50%) 0.650
 Seizures 1 (10%) 3 (30%) 0.582
 Dialysis 3(30%) 5(50%) 0.650
 Steroids started for low cardiac output syndrome prior to ECMO 3(30%) 7(70%) 0.179
Outcomes
 Duration of ECMO (hours) 282(304) 207(125) 0.484
 Peri-operative ventilation days 46(30) 46(76) 0.994
 Intensive care days post-operatively 38(137) 33(46) 0.782
 Total hospital days 73(52) 42(41) 0.154
 Death < 10 days post-operatively 1(10%) 3(30%) 0.582
 Death ≤ 30 days post-operatively 2(20%) 5(50%) 0.350
 Death by hospital discharge 3(30%) 5(50%) 0.650
 Death by 2 years of age 4 (40%) 7 (70%) 0.178
 General Adaptive Composite score on the ABAS-II n = 6 n = 3 0.756
69.8 (14.3) 69.3 (12.5)
General Adaptive Composite score < 70 on ABAS-II 4 (66%) 1 (33%) 0.961
  1. Data are given as n (%), mean (standard deviation). p value is for Fisher’s exact test (categorical data) or independent samples two-sided t test (continuous data)
  2. ABAS Adaptive Behavior Assessment System, CPB cardiopulmonary bypass, E-CPR extracorporeal cardiopulmonary resuscitation, ECMO extracorporeal membrane oxygenation, HLHS hypoplastic left heart syndrome, LVOTO left ventricle outflow tract obstruction, PCICU pediatric cardiac intensive care unit, PRISM III Score pediatric risk of mortality score, RACHS-1 risk adjustment for congenital heart surgery score, TAPVD total anomalous pulmonary venous drainage, TGA transposition of the great arteries, VSD ventricular septal defect
  3. aSurgery performed was as follows: Norwood-Sano for n = 6 HLHS, n = 2 HLHS variants, and n = 1 tricuspid atresia; Norwood-BT for n = 1 HLHS variant; TAPVD repair for n = 2 TAPVD; right ventricle to pulmonary artery conduit with closure of VSD for n = 1 pulmonary atresia; central shunt for n = 1 HLHS variant; pulmonary artery banding for n = 1 tricuspid atresia; arterial switch with repair of VSD, or atrial septal defect and LVOTO, or atrial septal defect, VSD, right ventricle muscle bundles, and LVOTO for n = 3 d-TGA; right ventricle outflow tract obstruction resection and pulmonary valve plasty for n = 1 poly-valvular disease with Noonan’s syndrome; Ross-Konno procedure for n = 1 with complex LVOTO (sub-aortic stenosis, aortic valve stenosis, hypoplastic aortic arch with coarctation)
Back to article page

Journal of Intensive Care

ISSN: 2052-0492