Circuit Change, Peri-Change Anticoagulation and Transfusion, and Survival in Pediatric Postcardiotomy Extracorporeal Membrane Oxygenation
Rattachement africain : jp. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Circuit and oxygenator changes during pediatric postcardiotomy extracorporeal membrane oxygenation (PC-ECMO) are clinically significant; however, their timing and management are poorly described. Moreover, outcomes beyond discharge remain unclear. We describe circuit changes, temporal trends in anticoagulant use and transfusion, and mid- to long-term survival in pediatric PC-ECMO. This study used a Japanese administrative database spanning 2014-2024. Cardiac surgery cases in patients aged <18 years with congenital heart disease were classified into PC-ECMO and non-ECMO groups. For the PC-ECMO group, we assessed the cumulative incidence of the first circuit change, temporal trends in anticoagulant use and transfusion around each change, and postoperative and post-discharge 1 year survival. Among 4,395 cases, 73 involved PC-ECMO. Of these, 24 (32.9%) required at least one circuit change, with a cumulative incidence of 33.1% (95% confidence interval [CI], 19.4-46.7) within 3 days. Anticoagulants were switched from heparin to nafamostat mesylate alone or no anticoagulation (p = 0.001), and fresh-frozen plasma transfusion increased on the day of change (p = 0.016). Postoperative 1 year survival was 0.566 (95% CI, 0.449-0.713); among those discharged alive, 1 year post-discharge survival was 0.967 (95% CI, 0.901-1.000). Circuit changes were common and occurred early after PC-ECMO initiation. Post-discharge survival was favorable among patients discharged alive.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Circuit Change, Peri-Change Anticoagulation and Transfusion, and Survival in Pediatric Postcardiotomy Extracorporeal Membrane Oxygenation
- Date Crossref
- 07/09/2026
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Kyoto University Department of Anesthesia and Intensive Care pays non établi dans la noticeUniversité ou école supérieure
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National Cerebral and Cardiovascular Center pays non établi dans la noticeÉtablissement de santé
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Kyoto University Hospital pays non établi dans la noticeÉtablissement de santé
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Department of Critical Care Medicine pays non établi dans la noticeInstitution
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Graduate School of Medicine and Public Health Department of Pharmacoepidemiology pays non établi dans la noticeUniversité ou école supérieure
Department of Anesthesia and Intensive Care — Kyoto University, National Cerebral and Cardiovascular Center et Kyoto University Hospital, avec 2 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.