New Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation.
Document Type
Article
Publication Date
11-1-2024
Identifier
DOI: 10.1097/MAT.0000000000002257
Abstract
The development of new right ventricular (RV) dysfunction after cannulation to venovenous (VV) extracorporeal membrane oxygenation (ECMO) and its association with worse outcomes is increasingly recognized in adult patients, however, no studies have evaluated this phenomenon in pediatric patients. We report results of a single-center retrospective cohort study at a large academic children's hospital. New RV systolic dysfunction was present in 48% (12/25) of pediatric patients on VV ECMO for acute respiratory distress syndrome (ARDS). There was no statistically significant difference in survival, duration of mechanical ventilation, or hospital length of stay between those with and without RV dysfunction. Over half (5/9, 56%) of survivors with RV dysfunction on ECMO had RV dilation or RV hypertrophy on post-ECMO echocardiograms, and in two patients the RV dysfunction persisted for months following decannulation. Cardiac catheterization and autopsy reports suggested that echocardiographic assessment of RV systolic function alone may not be sufficient to diagnose clinically relevant RV injury. This is the first study to report the prevalence of RV dysfunction on VV ECMO for pediatric ARDS. Future multicenter collaboration is needed to create a clinically relevant definition of pediatric "RV injury" and to further evaluate risk factors and outcomes of RV dysfunction.
Journal Title
ASAIO journal (American Society for Artificial Internal Organs : 1992)
Volume
70
Issue
11
First Page
994
Last Page
1000
MeSH Keywords
Humans; Extracorporeal Membrane Oxygenation; Retrospective Studies; Respiratory Distress Syndrome; Ventricular Dysfunction, Right; Child; Male; Female; Child, Preschool; Adolescent; Infant; Echocardiography
Keywords
Extracorporeal Membrane Oxygenation; Retrospective Studies; Respiratory Distress Syndrome; Right Ventricular Dysfunction; Echocardiography
Recommended Citation
Holton C, Shah S, Miller JO. New Right Ventricular Dysfunction in Pediatric Acute Respiratory Distress Syndrome on Venovenous Extracorporeal Membrane Oxygenation. ASAIO J. 2024;70(11):994-1000. doi:10.1097/MAT.0000000000002257
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