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