Faheem Muhammad Shaheer Bin, Khan Ahmed Ali, Cheema Shamikha, Akhtar Muzamil, Ashraf Danish Ali
Karachi Institute of Medical Sciences, KIMS, Karachi, Pakistan.
Foundation University Medical College, Islamabad, Pakistan.
Egypt Heart J. 2025 Jul 11;77(1):70. doi: 10.1186/s43044-025-00667-7.
Congenital heart diseases (CHDs) represent a significant healthcare challenge with incidence rates of 17.9 per 1000 live births. Extracorporeal membrane oxygenation (ECMO) has become an invaluable therapeutic option providing essential aid to support both cardiac as well as pulmonary failure.
A systematic search was performed using PubMed, Embase, and Scopus from 2000 till date. Observational studies involving pediatric patients with CHD undergoing cardiac surgery using ECMO were included. The main outcomes were to determine short-term mortality, weaning off ECMO, complications, hospital and ICU length of stay, and indications for ECMO. Assessment of the risk of bias of included studies was done by Newcastle-Ottawa scale.
24 retrospective observational studies, encompassing 1,658 patients, were ultimately included in our review. The overall incidence of mortality across these studies was 45.2%. Successful weaning from ECMO was achieved in 73.9% of patients. The most frequently reported complications included bleeding, which affected 42.9% of patients, renal failure in 42.5%, and sepsis in 27.5%. The mean duration of hospital stay was 47.8 ± 41.1 days, while the mean length of stay in the ICU was 33.4 ± 32.6 days.
ECMO benefits pediatric heart patients but comes with risks like bleeding and high mortality. Percutaneous techniques can reduce complications; more research on minimally invasive approaches is needed.
先天性心脏病（CHD）是一项重大的医疗挑战，发病率为每1000例活产中有17.9例。体外膜肺氧合（ECMO）已成为一种宝贵的治疗选择，为支持心脏和肺功能衰竭提供重要帮助。
使用PubMed、Embase和Scopus对2000年至今的文献进行系统检索。纳入涉及接受ECMO心脏手术的CHD儿科患者的观察性研究。主要结局是确定短期死亡率、脱机ECMO情况、并发症、住院和重症监护病房（ICU）住院时间以及ECMO的适应证。采用纽卡斯尔-渥太华量表对纳入研究的偏倚风险进行评估。
我们的综述最终纳入了24项回顾性观察性研究，共1658例患者。这些研究的总体死亡率为45.2%。73.9%的患者成功脱机ECMO。最常报告的并发症包括出血，影响42.9%的患者，肾衰竭占42.5%，败血症占27.5%。平均住院时间为47.8±41.1天，而在ICU的平均住院时间为33.4±32.6天。
ECMO对小儿心脏病患者有益，但存在出血和高死亡率等风险。经皮技术可减少并发症；需要对微创方法进行更多研究。
