Erwin Nicole, Zuk Jeannie, Kaufman Jon, Pan Zhaoxing, Carpenter Esther, Mitchell Max B, da Cruz Eduardo M
Department of Pediatrics, The Heart Institute, Children's Hospital Colorado, School of Medicine, University of Colorado at Denver, 13120 East 16th Avenue, Aurora, CO 80045, United States of America.
Cardiol Young. 2013 Apr;23(2):258-64. doi: 10.1017/S1047951112000777. Epub 2012 Jun 14.
Although survival to hospital discharge among children requiring extracorporeal membrane oxygenation support for medical and surgical cardio-circulatory failure has been reported in international registries, extended survival and re-hospitalisation rates have not been well described in the literature.
This is a single-institution, retrospective review of all paediatric patients receiving extracorporeal membrane oxygenation for primary cardiac dysfunction over a 5-year period.
A total of 74 extracorporeal membrane oxygenation runs in 68 patients were identified, with a median follow-up of 5.4 years from hospital discharge. Overall, 66% of patients were decannulated alive and 25 patients (37%) survived to discharge. There were three late deaths at 5 months, 20 months, and 6.8 years from discharge. Of the hospital survivors, 88% required re-hospitalisation, with 63% of re-admissions for cardiac indications. The median number of hospitalisations per patient per year was 0.62, with the first re-admission occurring at a mean time of 9 months after discharge from the index hospitalisation. In all, 38% of patients required further cardiac surgery.
Extended survival rates for paediatric hospital survivors of cardiac extracorporeal membrane oxygenation support for medical and post-surgical indications are encouraging. However, re-hospitalisation within the first year following hospital discharge is common, and many patients require further cardiac surgery. Although re-admission hospital mortality is low, longer-term follow-up of quality-of-life indicators is required
尽管国际登记处已报道了因内科和外科心循环衰竭而需要体外膜肺氧合支持的儿童存活至出院的情况，但文献中对延长生存期和再次住院率的描述并不充分。
这是一项单机构回顾性研究，对5年内因原发性心脏功能障碍接受体外膜肺氧合治疗的所有儿科患者进行分析。
共确定68例患者进行了74次体外膜肺氧合治疗，出院后中位随访时间为5.4年。总体而言，66%的患者脱管存活，25例患者（37%）存活至出院。出院后5个月、20个月和6.8年分别有3例晚期死亡。在出院存活患者中，88%需要再次住院，其中63%的再次入院是由于心脏相关指征。每位患者每年的住院中位数为0.62次，首次再次入院的平均时间为首次住院出院后9个月。总体而言，38%的患者需要进一步的心脏手术。
因内科和外科指征接受心脏体外膜肺氧合支持的儿科出院存活患者的延长生存期令人鼓舞。然而，出院后第一年内再次住院很常见，许多患者需要进一步的心脏手术。尽管再次入院的医院死亡率较低，但仍需要对生活质量指标进行长期随访。
