Abstract:
BACKGROUND:There are very sparse data on patient outcomes related to the use of extracorporeal membrane oxygenation (ECMO) prior to heart operation in children with congenital heart disease. This study was designed to evaluate this association using the Pediatric Health Information System (PHIS) database. HYPOTHESIS:We hypothesize that patients receiving ECMO prior to heart operation will have worse outcomes, including mortality, compared with patients receiving ECMO after heart operation. METHODS:Patients age ≤18 years receiving ECMO before or after pediatric heart operation (with or without cardiopulmonary bypass) at a PHIS-participating hospital from 2004 to 2013 were included. Multivariable logistic regression or Cox proportional-hazards models were fitted to study the effect of timing of ECMO initiation in relation to cardiac surgery on study outcomes. RESULTS:A total of 3498 patients from 42 hospitals qualified for inclusion. Of these, 494 (14%) received ECMO prior to heart operation (presurgery ECMO) and 3004 (86%) received ECMO after heart operation (postsurgery ECMO). Unadjusted mortality was significantly lower in the presurgery ECMO group compared with the postsurgery ECMO group (30% vs 45%; P < 0.0001). After adjusting for patient and center characteristics, odds of mortality were significantly lower in the presurgery ECMO group (odds ratio: 0.46, 95% confidence interval: 0.36-0.59, P < 0.0001). There were no significant differences in ECMO duration, length of hospital stay, and hospital charges between the 2 groups in adjusted models. CONCLUSIONS:This study suggests that ECMO can be used with satisfactory outcomes prior to heart operation in children with congenital heart disease.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Gupta P,Robertson MJ,Beam BW,Rettiganti Mdoi
10.1002/clc.22358subject
Has Abstractpub_date
2015-02-01 00:00:00pages
99-105issue
2eissn
0160-9289issn
1932-8737journal_volume
38pub_type
杂志文章,多中心研究abstract::Primum non nocere. Atrial fibrillation (AF) occurs commonly following coronary artery bypass graft surgery, although new onset atrial fibrillation in this setting is usually transient. When AF reverts or is converted to sinus rhythm it is unlikely to recur, whether or not the patient takes preventive medication. As no...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960211004
更新日期:1998-10-01 00:00:00
abstract::There is scant information regarding the effect of exercise training begun soon after hospital discharge for myocardial infarction (MI) with respect to subsequent improvement in exercise tolerance, enhancement of regional myocardial perfusion, or left ventricular function. Accordingly, 19 post-MI patients (mean age 53...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960150105
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abstract::Nicardipine a second-generation dihidropyridine calcium antagonist, has been approved in oral formulation for use in the United States, and is under review for parenteral use. Nicardipine is the most vascular-selective agent of this class currently approved and should, on theoretical grounds, be ideal for combination ...
journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960150403
更新日期:1992-04-01 00:00:00
abstract::The impact of transient myocardial ischemia on left ventricular function was examined by digital subtraction left ventricular angiography. Contrast medium was injected into the right pulmonary artery before, at 60 seconds of balloon inflation, and 10 minutes after balloon deflation. A total of 69 patients completed th...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章
doi:10.1002/clc.4960140808
更新日期:1991-08-01 00:00:00
abstract::Six patients undergoing aortic valve replacement had rare or unusual causes of isolated, pure aortic regurgitation. Two patients had congenitally bicuspid aortic valves with a false commissure (raphe) displaced to the aortic wall ("tethered bicuspid aortic valve"), two had floppy aortic valves, one had a congenital qu...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130812
更新日期:1990-08-01 00:00:00
abstract::In an open, multicenter extension of a short-term study, 159 patients with mild to moderate hypertension were treated with either ramipril monotherapy or a combination of ramipril and hydrochlorothiazide for up to 1 year. Patients started with either 5 mg ramipril once daily (responders in the short-term study) or a c...
journal_title:Clinical cardiology
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1002/clc.4960160111
更新日期:1993-01-01 00:00:00
abstract::Thirty-eight patients treated by atrial pacing were divided into three groups (Group I, patients with neither coronary stenosis nor anginal pain during pacing; Group II, patients with no coronary stenosis but having anginal pain during pacing; Group III, patients with coronary stenosis). The concentrations of adenosin...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120203
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abstract:BACKGROUND/HYPOTHESIS:SMARTWOMAN™ was designed to develop and assess the feasibility of a smartphone app to control cardiovascular risk factors in vulnerable diabetic women. METHODS:Fourteen African-American women with diabetes and without known cardiovascular disease were enrolled. A weight-scale, glucometer, sphygmo...
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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doi:10.1002/clc.23279
更新日期:2019-12-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.4960120910
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journal_title:Clinical cardiology
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doi:10.1002/clc.4960200321
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960190605
更新日期:1996-06-01 00:00:00
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journal_title:Clinical cardiology
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doi:10.1002/clc.4960100116
更新日期:1987-01-01 00:00:00
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pub_type: 临床试验,杂志文章,评审
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journal_title:Clinical cardiology
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journal_title:Clinical cardiology
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pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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更新日期:1999-10-01 00:00:00