Survival through staged palliation: fate of infants supported by extracorporeal membrane oxygenation after the Norwood operation

The Annals of Thoracic Surgery
Joshua M Friedland-LittleJennifer C Hirsch-Romano

Abstract

Infants supported by extracorporeal membrane oxygenation (ECMO) after a Norwood operation face in-hospital mortality rates of 60% to 70%. There are limited data on completion of staged palliation for the subset of patients who survive to hospital discharge. We performed a retrospective case-control study of 64 sequential patients at a single institution supported by ECMO after a Norwood operation. Primary endpoints were survival to hospital discharge, stage II palliation, and stage III palliation. Predictors of non-survival to each endpoint were identified with logistic regression. Survival was compared with a 3:1 era-matched group of control patients who underwent a Norwood operation but did not require ECMO. Survival to hospital discharge, stage II palliation, and stage III palliation was 43.8%, 35.9%, and 25.4%, respectively for ECMO cases. Factors independently associated with non-survival to hospital discharge included female gender, ECMO 7 days or greater, and need for renal replacement therapy on ECMO. Non-Caucasian race and ECMO 7 days or greater were independently associated with non-survival to stage II, while non-Caucasian race, lower birth weight, and ECMO 7 days or greater were independently associated with non-sur...Continue Reading

References

Jan 26, 2006·The Journal of Thoracic and Cardiovascular Surgery·Chad N StasikRichard G Ohye
Jul 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·T K Susheel KumarAchintya Moulick
Feb 22, 2012·The Journal of Thoracic and Cardiovascular Surgery·James S TweddellUNKNOWN Pediatric Heart Network Investigators
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Citations

Jun 6, 2014·Intensive Care Medicine·Graeme MacLarenRavi R Thiagarajan
Aug 15, 2014·Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs·Takaya HoashiHajime Ichikawa
Feb 4, 2014·The Annals of Thoracic Surgery·James S Tweddell
Nov 26, 2014·Circulation Journal : Official Journal of the Japanese Circulation Society·Masaki KajimotoMichael A Portman
May 20, 2008·Journal of Pediatric Surgery·Robert BairdUNKNOWN Canadian Pediatric Surgery Network
Nov 3, 2016·Pediatric Cardiology·Richard P FernandezClifford L Cua
Mar 16, 2017·Critical Care Medicine·Titus ChanDavid Michael McMullan
Dec 31, 2014·World Journal for Pediatric & Congenital Heart Surgery·Bahaaldin AlsoufiShriprasad Deshpande
Oct 17, 2018·World Journal for Pediatric & Congenital Heart Surgery·Bahaaldin AlsoufiKirk Kanter
Oct 19, 2019·The International Journal of Artificial Organs·Nicole De Jesus-BrugmanChristopher W Mastropietro
Jul 8, 2014·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·D Michael McMullan
Jul 6, 2017·World Journal for Pediatric & Congenital Heart Surgery·Lena K EschenbachJulie Cleuziou
Aug 20, 2019·The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation·Roberto LorussoGlenn Whitman

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