Risk factors for extracorporeal membrane oxygenation in children with fulminant myocarditis:a single-center experience
YE Xiao-ting1
LI Xu-feng2
HU Yan3
CHEN Yi-hao4
CHEN Chun-ling5
ZHANG Jing-wen3
WANG Chun3
YANG Ai-mei3
WU Jia-xing3
SUN Yue-yu3
ZHOU Cheng-bin6
ZHENG Gui-lang7
GUO Yu-xiong8
1.Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,China;Department of Pediatric Intensive Care Unit,Department of Pediatrics,Guangdong Pro-vincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,106 zhongshan Er Road,Guangzhou,Guangdong,Chi-na2.Department of Pediatrics,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China3.Department of Pediatric Intensive Care Unit,Department of Pediatrics,Guangdong Pro-vincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,106 zhongshan Er Road,Guangzhou,Guangdong,Chi-na4.Department of Pediatrics,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510120,China5.Department of Pediatric Intensive Care Unit,Department of Pediatrics,Guangdong Pro-vincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,106 zhongshan Er Road,Guangzhou,Guangdong,Chi-na;Second School of Clinical Medi-cine,Southern Medical University,Guangzhou,Guangdong,China6.Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,China7.Department of Pediatric Intensive Care Unit,Department of Pediatrics,Guangdong Pro-vincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,106 zhongshan Er Road,Guangzhou,Guangdong,Chi-na;Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,China8.Department of Pediatric Intensive Care Unit,Department of Pediatrics,Guangdong Pro-vincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,106 zhongshan Er Road,Guangzhou,Guangdong,Chi-na;Guangdong Cardiovascular Institute,Guangdong Provincial People's Hospital(GDPH),Guangdong Academy of Medical Sciences,Guangzhou,Guangdong,China;Second School of Clinical Medi-cine,Southern Medical University,Guangzhou,Guangdong,China
摘要：Objective Research on the clinical features of and risk factors for extracorporeal membrane oxy-genation(ECMO)in pediatric fulminant myocarditis(FM)are currently limited.We aimed to investigate the clini-cal features and outcomes of patients with pediatric FM,and to analyze the actors associated with the need for EC-MO.Methods We analyzed a retrospective cohort of patients with FM admitted to the Pediatric Department of Guangdong Provincial People's Hospital,China,between 1 January 2009 and 31 December 2021.The demographic and physiological variables were summarized and compared between patients treated with and without ECMO.Re-sults Thirty-four patients met the criteria for FM(14 male,20 female;mean age 8.0±3.7 years,range 4 months to 15.6 years.Three patients abandoned therapy,twenty-nine patients(85.3％)survived to hospital discharge.Nine pa-tients(26.5％)received ECMO,and eight(88.9％)of these survived.At admission,patients requiring ECMO had significantly higher levels of creatine kinase MB(CK-MB;112.1 vs 77.7 U/L,p=0.045),lower left ventricular ejection fraction(LVEF;37.0％vs 49.5％,p=0.033),and fractional shortening(16.2％vs 25.9％,p=0.012).Dur-ing disease progression,the ECMO group also had significantly higher peak CK-MB(109.3 vs 60.5 U/L,p=0.041),serum B-type natriuretic peptide(35,000 vs 19,433 pg/mL,p=0.001),and troponin Ⅰ(12.6 vs 6.5 ng/mL,p=0.012),and significantly lower minimum LVEF(25.0％vs 45.8％,p＜0.001).Mechanical ventilation and days of mechanical ventilation were significantly associated with the need for ECMO.Patients in the ECMO group had significantly longer intensive care unit stays than patients without ECMO(15.0 vs 5.0 days,p＜0.001).Conclu-sion Initial levels of CK-MB,LVEF,and fractional shortening are possible risk factors for ECMO in children with FM.[S Chin J Cardiol 2023;24(2):65-73]
机标关键词：childrenriskwithexperienceextracorporealfactorsfulminantmembrane
论文发表日期：2023-06-30
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：9( 65-73 )
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