Risk factors for prolonged mechanical ventilation for children on ventricular assist device support

The Annals of Thoracic Surgery
Parthak ProdhanUmesh Dyamenahalli

Abstract

Patients with end-stage heart failure possess many attributes that place them at risk for prolonged mechanical ventilation (MV). However, there are only limited data on MV support among children after ventricular assist device (VAD) implantation. We report the duration of MV after VAD placement, indications for respiratory support in the postimplantation period, and associated patient factors. This single-center retrospective study included 43 consecutive children (aged <18 years) with end-stage heart failure who were supported with a VAD as a bridge to transplantation from January 2005 to December 2011. Multivariable analysis was performed using the multiple Poisson regression model for the duration of MV. Overall, 33% (n = 14) remained on MV until heart transplant or death. Of those requiring pre-VAD extracorporeal membrane oxygenation (ECMO) support, 63% (n = 12 of 19) remained on MV until heart transplant or death compared with 8% (n = 2 of 24) among those not on ECMO before VAD (p < 0.001). Patients with moderate or severe mitral regurgitation while on VAD support had 1.7-times more MV days compared with those with none or trivial on-VAD mitral regurgitation. In addition, previous support on ECMO, those with moderate or se...Continue Reading

References

May 17, 2006·Circulation·Elizabeth D BlumeUNKNOWN Pediatric Heart Transplant Study Investigators
Jul 20, 2010·Artificial Organs·Hannah ZimmermanJack Copeland
Feb 22, 2011·The Journal of Thoracic and Cardiovascular Surgery·Roland HetzerMichael Hübler
Sep 3, 2011·Journal of the American College of Cardiology·Ye FanRoland Hetzer
Aug 10, 2012·The New England Journal of Medicine·Charles D FraserUNKNOWN Berlin Heart Study Investigators
Sep 26, 2013·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Jane CassidyAnn Karimova

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Citations

Aug 5, 2016·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Jonathan ByrnesAngela Lorts
Mar 23, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Mohamed S NassarBari Murtuza

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