Survival and Neurocognitive Outcomes After Cardiac Extracorporeal Life Support in XXXX Less Than Five Years of Age: A Ten Year Cohort.

@entity1 @entity16 @entity7971 @entity880
BACKGROUND: -Survival following pediatric cardiac extracorporeal life support (ECLS) is guarded and @entity16 varies widely. Our objective is to report our ten-year experience with cardiac ECLS, including survival and kindergarten entry neurocognitive outcomes; to identify predictors of mortality or adverse neurocognitive outcomes; and to compare two eras, before and after 2005. METHODS AND RESULTS: -From 2000-2009, 98 @entity1 had venoarterial cardiac ECLS. Sixty-four @entity1 (65%) survived to hospital discharge and 50 (51%) survived up to 5 years of age. Neurocognitive follow-up of survivors was completed at mean (SD) age of 52.9 (8) months using Wechsler Preschool and Primary Scale of Intelligence. Logistic regression analysis found the longer time (hours) for @entity880 to fall below 2 mmol/L on ECLS (HR 1.39; 95%CI 1.05, 1.84; P= 0.022) and the amount of platelets (ml/kg) given in the first 48 hours (hazard ratio [HR] 1.18; 95% CI 1.06, 1.32; P= 0.002) were independently associated with higher in-hospital mortality. Receiving ECLS after the year 2005 was independently associated with lower risk of in-hospital mortality (HR 0.36; 95%CI 0.13, 0.99; P= 0.048). Extracorporeal cardiopulmonary resuscitation (ECPR) was not independently associated with mortality or neurocognitive outcomes. @entity7971 was not independently associated with neurocognitive outcomes. The Full-Scale IQ of survivors without chromosomal abnormalities was 79.7 (16.6) with 25% below 2SD of the population mean. CONCLUSIONS: -Mortality has improved over time; time for @entity880 to fall on ECLS and volume of platelets transfused are independent predictors of mortality. ECPR and @entity7971 were not independently associated with neurocognitive outcomes.
