Pediatric cardiac patients have better quality of life with ECMO

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childrens hospital of PhiladelphiaA new study has shown that cardiac patients who have been treated for extracorporeal membrane oxygenation (ECMO) have had overall favorable outcomes among survivors.

ECMO gives breathing and heart support to critically ill children – artificially removing carbon dioxide and oxygenating red blood cells outside the body – while doctors treat other illnesses, according to the researchers at the Children’s Hospital of Philadelphia who performed the ECMO study.

The study included 396 patients who had cardiac disease. Each patient was treated with ECMO at the Children’s Hospital of Philadelphia between 1995 and 2012. There was an overall mortality of 66% at an average follow up of six years after treatment.

A majority of the families of the patients reported that there was positive outcomes with health and physical limitations. Over 90% of the families said that the patients had good or excellent health while 86% reported having mild or no physical limitations.

The study also reported that there was discrepancies between family-reported favorable outcomes and a high rate of medical and behavioral issues. About 25% of patients who received ECMO had below-average school performance and needed special educations while nearly 50% had learning disabilities, as reported by parents.

Pediatric cardiologist at the Children’s Hospital of Philadelphia Dr. Matthew D. Elias, who is also the first author on the study, reports that ECMO use in patients with congenital heart disease (CHD) have seen and increase over the past several decades as cardiologists become more experienced in using ECMO in more complex patients.

“Several factors have potentially improved long-term outcomes, such as increasing experience with ECMO and CHD in general. But the inclusion of a more medically complex population in the recent era may mitigate these improvements in outcomes, accounting for the fact that overall mortality rates haven’t changed much,” said Matthew J. O’Connor, a Children’s Hospital of Philadelphia pediatric cardiologist and senior author on the study said in a press release.

The research was published in the Pediatric Critical Care Medicine journal.

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