Abstract
Background: Extracorporeal membrane oxygenation (ECMO) provides
circulatory support in children with congenital heart disease,
particularly in the setting of cardiopulmonary failure and inability to
wean from cardiopulmonary bypass. This study summarized the clinical
application of ECMO in treatment of heart failure after cardiac surgery
in neonates. Methods: Clinical data of 23 neonates who received ECMO
support in our center from January 2017 to June 2019 were
retrospectively analyzed. Results: Twenty-three neonates, aged from 0 to
25 days and weight between 2300 to 4500 g, with heart failure
post-cardiotomy were supported with ECMO. The successful weaning rate
was 78.26% and discharge rate was 52.17%. Bleeding and residual
malformation were the most common complications. The univariate analysis
showed that non-survivors were related to the factors such as higher
lactate value of ECMO 12h, 24h (P=0.008, 0.001, respectively), longer
time to lactate normalization (P=0.001), lactate>10 mmol/L
before ECMO (P=0.01), lower weight (P=0.01), longer ECMO duration
(P=0.005), lower platelet count (P=0.001), more surgical site bleeding
(P=0.001) and surgical residual malformation (P=0.04). Further logistic
regression analysis revealed that higher lactate value of ECMO 24h
(P=0.003), longer ECMO duration (P=0.015) and surgical site bleeding
(P=0.025) were independent risk factors. Conclusions: ECMO was an
effective technology to support the neonates with cardiopulmonary
failure after open-heart surgery. Control the lactate acidosis and
surgical site bleeding event may be helpful for patients’ recovery.