Extracorporeal membrane oxygenation combined with hypothermia therapy for children patients with refractory cardiac arrest after congenital heart disease surgery: A randomized controlled trial
- VernacularTitle:体外膜肺氧合联合亚低温治疗在儿童先天性心脏病术后心跳骤停中应用的随机对照试验
- Author:
LUO Dandong
1
;
ZHUANG Jian
1
;
ZHU Weizhong
1
;
ZHOU Chengbin
1
;
WU Lan
1
;
CHEN Miaoyun
1
;
LI Xiaofeng
1
Author Information
1. Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangzhou, 510100, P.R.China
- Publication Type:Journal Article
- Keywords:
Heart defects, congenital;
cardiac surgical procedures;
extracorporeal membrane oxygenation;
hypothermia therapy;
cardiac arrest
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2017;24(8):580-584
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the value of extracorporeal membrane oxygenation(ECMO) combined with hypothermia therapy for children patients with refractory cardiac arrest after congenital heart disease surgery. Methods From January 2013 to June 2016, we conducted a prospective study of 23 children (18 males, 5 females at age of 7±11 months) who underwent ECMO for refractory cardiac arrest after congenital heart disease surgery. All patients were randomly divided into two groups: a standard group (11 patients) and a hypothermia group (12 patients). The patients of the standard group received standard therapy (the core body temperature maintaining at 37.0℃) and the hypothermia group received hypothermia therapy (the core body temperature maintaining at 33.0℃). The hospital discharge rate, the rate of weaning from ECMO and the morbidity were compared between the two groups. Results Eleven of 23 patients (47.8%) were weaned from ECMO successfully and 7 of 23 patients (30.4%) discharged from hospital. The hospital discharge rate between the hypothermia group (n=6, 50.0%) and the standard group (n=1, 9.1%) had no statistical difference (χ2=4.537, P=0.069). The rate of weaning from ECMO of the hypothermia group (n=9, 75.0%) was higher than that of the standard group (n=2, 18.2%, χ2=7.425, P=0.006). The morbidity between the two groups had no statistical difference. Conclusion Extracorporeal cardiopulmonary resuscitation can improve the survival rate of the children who suffered from refractory cardiac arrest after congenital heart disease surgery. There is no evidence that ECMO combined with hyperthermia therapy is better than the only ECMO in improving the discharge rate. But ECMO combined with hypothermia therapy has higher rate of weaning from ECMO than that of the only ECMO.
