Disease Oriented ECMO Results; Specific Considerations for Different Pathologies
Ergin Arslanoğlu1, Kenan Abdurrahman Kara1, Fatih Yiğit1, Babürhan Özbek1, Yasemin Yavuz2, Fatma Ukil Işıldak2, Eylem Tunçer1, Nihat Çine1, Hakan Ceyran1
1Department of Pediatric Cardiovascular Surgery, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
2Department of Anaesthesiology and Reanimation, Kartal Koşuyolu High Specialization Training and Research Hospital, Istanbul, Turkey
Keywords: Cardiac morphology; pediatric ECMO; RACHS score
Introduction: Extracorporeal membrane oxygenation (ECMO), whose use has increased with technological developments in pediatric heart surgery, is a life-saving treatment modality that is used in patients with cardiac or pulmonary insufficiency who are unresponsive to medical treatment. We investigated the effect of operation technique and cardiac morphology of patients undergoing pediatric cardiac surgery in our clinic on ECMO prognosis in this retrospective cohort study.
Patients and Methods: Seventy patients in need of ECMO after pediatric heart surgery were enrolled be- tween May 2010 and April 2020 in our clinic. 44.3% (n= 31) of patients were female and 55.7% (n= 39) were male. Their ages ranged from 0 to 575 months, with a mean of 32.59 ± 147.26. RACHS-1 was 25%, RACHS-2 was 23.07%, RACHS-3 was 33.33%, RACHS-4 was 35.71%, RACHS-5 was 100%, and RACHS-6 was 50% according to the ECMO result. No statistically significant difference was found between mortality and RACHS scoring.
Results: As a consequence, scoring systems used in the evaluation and measurement of ECMO use in the pediatric age group can be deceptive.
Conclusion: We attribute this to the fact that ECMO is a complex and complicated treatment that affects all systems in general and has a lot of mechanical and physiological complications. We think that the combination of scoring systems used in these patients with other scoring methods will give more accurate results than using them alone.