RT Journal Article
SR Electronic
T1 Prognostic factors in children with acute fulminant myocarditis receiving venoarterial extracorporeal membrane oxygenation
JF World Journal of Pediatric Surgery
JO World Jnl Ped Surgery
FD BMJ Publishing Group Ltd
SP e000271
DO 10.1136/wjps-2021-000271
VO 5
IS 1
A1 Sun, Mingwei
A1 Zong, Qing
A1 Ye, Li Fen
A1 Fan, Yong
A1 Yang, Lijun
A1 Lin, Ru
YR 2022
UL http://wjps.bmj.com/content/5/1/e000271.abstract
AB Background Pediatric acute fulminant myocarditis (AFM) is a very dangerous disease that may lead to acute heart failure or even sudden death. Previous reports have identified some prognostic factors in adult AFM; however, there is no such research on children with AFM on venoarterial extracorporeal membrane oxygenation (VA-ECMO). This study aimed to find relevant prognostic factors for predicting adverse clinical outcomes.Methods A retrospective analysis was performed in an affiliated university children’s hospital with consecutive patients receiving VA-ECMO for AFM from July 2010 to November 2020. These children were classified into a survivor group (n=33) and a non-survivor group (n=8). Patient demographics, clinical events, laboratory findings, and electrocardiographic and echocardiographic parameters were analyzed.Results Peak serum creatinine (SCr) and peak creatine kinase isoenzyme MB during ECMO had joint predictive value for in-hospital mortality (p=0.011, AUC=0.962). Based on multivariable logistic regression analysis, peak SCr level during ECMO support was an independent predictor of in-hospital mortality (OR=1.035, 95% CI 1.006 to 1.064, p=0.017, AUC=0.936, with optimal cut-off value of 78 μmol/L).Conclusion Tissue hypoperfusion and consequent end-organ damage ultimately hampered the outcomes. The need for left atrial decompression indicated a sicker patient on ECMO and introduced additional risk for complications. Earlier and more cautious deployment would likely be associated with decreased risk of complications and mortality.No data are available. All free text entered below will be published.