{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T02:46:12Z","timestamp":1767235572892,"version":"3.40.5"},"reference-count":23,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Artificial Organs"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The increasing complexity of congenital cardiac surgery has led to greater utilization of extracorporeal membrane oxygenation (ECMO) support for children post\u2010surgery. This study aims to identify risk factors for mortality and brain injury in pediatric patients requiring post\u2010cardiotomy ECMO and to evaluate their neurological outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective study includes pediatric patients with congenital heart diseases who required ECMO after surgery. Risk factors for in\u2010hospital mortality and brain injury were assessed. Neurodevelopmental status was determined using the Pediatric Cerebral Performance Category (PCPC) Scale at discharge and during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Between October 2014 and May 2021, 2651 pediatric patients underwent cardiac surgery, with 90 (3.4%) requiring ECMO. The mean age was 0.6\u2009years, ranging from 1\u2009day to 13\u2009years and 7\u2009months. ECMO was implemented for 45 patients due to CPB weaning failure (NW\u2010CPB), 24 due to postoperative low\u2010cardiac output syndrome (LCOS), and 21 for extracorporeal cardiopulmonary resuscitation (E\u2010CPR). ECMO weaning was achieved in 73 patients (81%), with an overall mortality rate of 36%. Pre\u2010implant lactate levels (OR: 1.13, 95% CI: 1.03\u20131.25; <jats:italic>p<\/jats:italic>\u2009=\u20090.009) and peak bilirubin levels (OR: 1.04, 95% CI: 0.87\u20131.24; <jats:italic>p<\/jats:italic>\u2009=\u20090.69) were risk factors for in\u2010hospital mortality. Survival rates were 79% for LCOS, 60% for NW\u2010CPB, and 48% for E\u2010CPR. Brain injury incidence was 33%, with E\u2010CPR being a significant risk factor (<jats:italic>p<\/jats:italic>\u2009=\u20090.006) and NW\u2010CPB being protective (<jats:italic>p<\/jats:italic>\u2009=\u20090.001). Follow\u2010up in November 2023 showed significant improvement in neurodevelopmental status (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Elevated pre\u2010implant lactate and elevated bilirubin levels during ECMO are major risk factors for mortality. E\u2010CPR is the primary risk factor for brain injury. Follow\u2010up revealed significant improvements in neurodevelopmental outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aor.14842","type":"journal-article","created":{"date-parts":[[2024,8,17]],"date-time":"2024-08-17T05:33:40Z","timestamp":1723872820000},"page":"1525-1535","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Post cardiotomy extracorporeal membrane oxygenation in pediatric patients: Results and neurodevelopmental outcomes"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3956-333X","authenticated-orcid":false,"given":"Alessandro","family":"Varrica","sequence":"first","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Cotza","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro Lo","family":"Rito","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Satriano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anesthesia and Intensive Care IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giovanni","family":"Carboni","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Saracino","sequence":"additional","affiliation":[{"name":"Pediatric and Adult Congenital Heart Centre IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Reali","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmood","family":"Hafdhullah","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Ranucci","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Anesthesia and Intensive Care IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Giamberti","sequence":"additional","affiliation":[{"name":"Department of Congenital Cardiac Surgery IRCCS Policlinico San Donato  Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"278","article-title":"The history and development of extracorporeal support","volume":"70","author":"Fortenberry JD","year":"2013","journal-title":"NeuroImage"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000119425.04364.CF"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12519-023-00768-w"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2009.02.015"},{"issue":"6","key":"e_1_2_10_6_1","first-page":"619","article-title":"Relationship of ECMO duration with outcomes after pediatric cardiac surgery: a multi\u2010institutional analysis","volume":"81","author":"Gupta P","year":"2015","journal-title":"Minerva Anestesiol"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200007000-00072"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/cc11454"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2019.07.004"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40560-018-0326-4"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2008.03.007"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semtcvs.2020.11.030"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2015.12.029"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2006.02.011"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-018-1964-y"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-009-1508-2"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2003.50062"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-011-2248-7"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei018"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/039139880803100210"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0029-1231053"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2012.11.014"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000000236"},{"issue":"1","key":"e_1_2_10_24_1","first-page":"47","article-title":"Neurodevelopmental outcomes after pediatric cardiac ECMO support","volume":"19","author":"Chrysostomou C","year":"2013","journal-title":"Front Pediatr"}],"container-title":["Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/aor.14842","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T09:52:59Z","timestamp":1731405179000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/aor.14842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":23,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1111\/aor.14842"],"URL":"https:\/\/doi.org\/10.1111\/aor.14842","archive":["Portico"],"relation":{},"ISSN":["0160-564X","1525-1594"],"issn-type":[{"type":"print","value":"0160-564X"},{"type":"electronic","value":"1525-1594"}],"subject":[],"published":{"date-parts":[[2024,8,16]]},"assertion":[{"value":"2024-04-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-08-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}