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Erschienen in: Pediatric Cardiology 7/2010

01.10.2010 | Original Article

Favorable Outcome of Pediatric Fulminant Myocarditis Supported by Extracorporeal Membranous Oxygenation

verfasst von: Elhanan Nahum, Ovdi Dagan, Amiram Lev, Golan Shukrun, Gabriel Amir, George Frenkel, Jacob Katz, Berant Michel, Einat Birk

Erschienen in: Pediatric Cardiology | Ausgabe 7/2010

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Abstract

Myocarditis among pediatric patients varies in severity from mild disease to a fulminant course with overwhelming refractory shock and a high risk of death. Because the disease is potentially reversible, it is reasonable to deploy extracorporeal membranous oxygenation (ECMO) to bridge patients until recovery or transplantation. This study aimed to review the course and outcome of children with acute fulminant myocarditis diagnosed by clinical and echocardiographic data only who were managed by ECMO because of refractory circulatory collapse. A chart review of a single center identified 12 children hospitalized over an 8-year period who met the study criteria. Data were collected on demographics, diagnosis, disease course, and outcome. The patients ranged in age from 20 days to 8 years (25.5 ± 29.6 months). Echocardiography showed a severe global biventricular decrease in myocardial function, with a shortening fraction of 12% or less. Ten children (83.3%) were weaned off extracorporeal support after 100–408 h (mean, 209.9 ± 82.4 h) and discharged home. Two patients died: one due to multiorgan failure and one due to sustained refractory heart failure. During a long-term follow-up period, all survivors showed normal function in daily activities and normal myocardial function. The study showed that ECMO can be safely and successfully used for children with acute fulminant myocarditis diagnosed solely on clinical and radiographic grounds who need mechanical support. These patients usually have a favorable outcome, regaining normal or near normal heart function without a need for heart transplantation.
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Metadaten
Titel
Favorable Outcome of Pediatric Fulminant Myocarditis Supported by Extracorporeal Membranous Oxygenation
verfasst von
Elhanan Nahum
Ovdi Dagan
Amiram Lev
Golan Shukrun
Gabriel Amir
George Frenkel
Jacob Katz
Berant Michel
Einat Birk
Publikationsdatum
01.10.2010
Verlag
Springer-Verlag
Erschienen in
Pediatric Cardiology / Ausgabe 7/2010
Print ISSN: 0172-0643
Elektronische ISSN: 1432-1971
DOI
https://doi.org/10.1007/s00246-010-9765-y

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