Recommendations for weaning off cardiopulmonary support in children with fulminant myocarditis.

نویسندگان

  • Hiroshi Kanamaru
  • Kensuke Karasawa
  • Osamu Abe
  • Michio Miyashita
  • Mamoru Ayusawa
  • Naokata Sumitomo
  • Tomoo Okada
  • Kensuke Harada
  • Hideo Mugishima
چکیده

BACKGROUND The purpose of this study was to determine the appropriate recommendations for weaning off cardiopulmonary support (CPS) in children with fulminant myocarditis. METHODS AND RESULTS Four consecutive patients diagnosed with fulminant myocarditis who were treated with CPS were enrolled (mean age: 9 years). The relationships between timing of weaning from CPS and various factors, including bleeding episodes, platelet count, serum concentration of the MB isoform of creatine kinase (CK-MB), echocardiographic findings, and the mixed venous blood oxygen saturation (SvO2), were retrospectively analyzed. All patients had CPS performed safely for a mean duration of 53.1 h without exchange of the circuit. Three of the 4 patients had a bleeding episode before discontinuation. The minimum platelet count occurred during weaning in all 4 patients. The peak serum CK-MB concentration when initiating CPS was higher than the peak value on the day of weaning. Echocardiographic findings before stopping CPS were similar to those after weaning. The SvO2 was 62.5% when initiating CPS and 71.3% before weaning. CONCLUSIONS In children with fulminant myocarditis CPS can be used without exchanging the circuit and can be discontinued before bleeding episodes become symptomatic, with improvement in the biomarkers and SvO2 on weaning off CPS.

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عنوان ژورنال:
  • Circulation journal : official journal of the Japanese Circulation Society

دوره 71 10  شماره 

صفحات  -

تاریخ انتشار 2007