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Dismal Outcomes of Second-Run Extracorporeal Life Support in the Paediatric Population.
- Source :
-
Heart, Lung & Circulation . Mar2019, Vol. 28 Issue 3, p450-454. 5p. - Publication Year :
- 2019
-
Abstract
- <bold>Background: </bold>In 2011 we reported unfavourable outcomes of second-run extracorporeal life support (ECLS) in children. We wanted to investigate whether this previous report affected our strategy and modified our long-term outcomes.<bold>Methods: </bold>Between 1988 and 2015, 31 patients underwent a second-run ECLS. Median age at the time of first support was 9days (0-16 years). Median length of support for the first and second runs were 4.7days (0.1-10) and 3.6days (0.5-8.7) respectively, with an interval of 1.8days (0.1-66) between supports.<bold>Results: </bold>There was an increasing trend in the number of patients undergoing second-run ECLS after our report: 21 patients between 1988 and mid-2010 (0.9 patients/year) and 10 between mid-2010 and 2015 (two patients/year) (p=0.06). However, among all the patients who underwent ECLS, the proportion of second-run ECLS was not different before and after 2010 (4% vs. 4.2% respectively, p=0.92). While 58% of patients (18/31) survived weaning of support, only 23% (7/31) survived to hospital discharge and 14% (5/31) were still alive after hospital discharge at a median of 6.5 years (1.2-11.6). The three patients who had positive long-term outcomes had the second-run ECLS instituted to allow for major cardiac operations.<bold>Conclusions: </bold>Compassionate use of second-run ECLS is difficult to refuse but one should be aware that its outcomes are dismal. In our centre, benefits seem to be limited to cases where the second-run ECLS allows for a major cardiac intervention. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 14439506
- Volume :
- 28
- Issue :
- 3
- Database :
- Academic Search Index
- Journal :
- Heart, Lung & Circulation
- Publication Type :
- Academic Journal
- Accession number :
- 134402630
- Full Text :
- https://doi.org/10.1016/j.hlc.2018.02.001