Author contribution
Yu Xin-di designed the study and drafed the manuscript, Yang Yin-yu,
Zhang Wei, Guo Zheng, Shen Jia, Zhuoming Xu and Haibo Zhang performed
data collection, Wang Wei helped to perform data analysis. All authors
read and approved the final manuscript.
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.
Keywords : Neonate, Extracorporeal membrane oxygenation,
Congenital heart disease, Open heart surgery