Extracorporeal life support in perioperative care of pediatric cardiac surgical patients in China

Ai Xuefeng; Gong Yiqi; Hong Xiaoyang; Wang Wei; Liu Jinping; Zhou Chengbin; Zhang Xiaohua; Zhao Zhe; Chen Jin; Miao Na; Lin Ru; Lu Ting; He Jun; Huang Guodong

doi:10.13498/j.cnki.chin.j.ecc.2018.01.02

Abstract：Objective To summarize extracorporeal life support ( ECLS) cases in the perioperative period of pediatric cardiac surgery in mainland China (excluding Hong Kong, Macao, Taiwan). Methods A questionnaire survey was conducted to investigate pediatric extracorporeal life support in China before June 30, 2017. Results A total of 43 hospitals in China that carried out children open-heart surgery participated in this questionnaire survey and it covered all hospitals that performed more than 300 open-heart surgeries per year. Among them, ECLS has been undertaken in children who received cardiac surgery in 30 hospitals, most of which located in the more developed regions. The higher the number of operations, the higher the proportion of ECLS employed. A total of 457 cases of extracorporeal membrane oxygenation ( ECMO) were used in these hospitals during the children's heart perioperative period. This survey included 375 children (＞28 days to≤18 years) with 229 (61% ) cases successfully weaned and 166 ( 44%) cases survved, and 77 neonates (≤28 days) with 37 (48%) cases successfully weaned and 25 (32%) cases discharged. The neonatal survival rate was significantly lower than that in older children. Five patients were supported with ECMO after heart transplantation with 4 (80% ) cases successfully weaned and discharged. A total of 39 cases were supported with ventricular assist device (VAD) ， with left ventricular assist device (LVAD) in 38 cases and right ventricular assist device (RVAD) in 1 case. Conclusions ECLS has been used for decades in China, but the development is uneven and gaps among regions are still obvious. Although the survival rate is acceptable ，differences among centers are still considerable and the results are under the international standard.