Acute cardiac care & resuscitation
Extracorporeal cardiopulmonary resuscitation outcomes in pre-Glenn single ventricle infants: Analysis of a ten-year dataset
Authors' conclusion
In our cohort of pre-Glenn single ventricle infants, survival after ECPR for in-hospital cardiac arrest was 37.9%. Number of hours on ECMO and seizures post-ECMO cannulation were associated with decreased odds of survival. Single ventricle infants who had undergone Norwood palliation pre-arrest were more likely to survive to hospital discharge.
Study context
- Population
- Single ventricle patients prior to superior cavopulmonary anastomosis, aged 180 days or younger, who underwent extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest (IHCA) between January 2012 and December 2021subjects with index ECPR events
- Participants
- 420 participants
- Exposure
- Subjects who survived to hospital discharge after ECPR were compared to subjects who did not survive to hospital discharge
- Survivorsn = 159
- Outcome
- Survival to hospital discharge
Methodological detailsExtracorporeal Life Support Organization (ELSO) Registry, univariate logistic regression followed by multivariable logistic regression
- Extracorporeal Life Support Organization (ELSO) Registry
- Univariate logistic regression followed by multivariable logistic regression
Main finding
As reported in the abstract
Survival to hospital discharge
159 of 420
37.9%
Observational data: associations, not effects.
Further findings
Median number of hours on ECMO · significantly higher among non-survivors
P < 0.001
Seizures by electroencephalography · significantly higher among non-survivors
P = 0.033
Need for renal replacement therapy · significantly higher among non-survivors
P = 0.023
Presence of Norwood operation
P = 0.032
| Outcome | Adjusted odds ratio (95% CI) | |
|---|---|---|
| Survival to hospital discharge, multivariable logistic regressionNumber of ECMO hours | 0.95 (0.92–0.98) | |
| 0.512Adjusted odds ratio (log scale) |
Survival to hospital discharge, multivariable logistic regression
| Adjusted odds ratio (95% CI) | ||
|---|---|---|
| Presence of seizuresDecreased odds of survival | 0.57 (0.33–0.97) | |
| Presence of Norwood operation pre-arrestIncreased odds of survival | 1.53 (1.01–2.32) | |
| 0.20.5125Adjusted odds ratio (log scale) |
- Survival to hospital discharge, multivariable logistic regression: decreased odds of survival; decrease in odds of survival by 5% for every 12 h on extracorporeal membrane oxygenation (ECMO)
Cohort characteristics
- Median weight (IQR 2.8, 3.8) kg
- 3.14
- Hypoplastic left heart syndrome
- 354/420; 84.2%
- Had undergone a Norwood operation
- 47.4% (199/420)
Survival after ECPR in the subgroup of Norwood patients
- Survival among Norwood patients
- 43.2%
- Subgroup
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
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