{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:31:35Z","timestamp":1787596295009,"version":"build-2736575974"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Pediatr (Phila)"],"abstract":"<jats:p>Pediatric myocarditis presents with heterogeneous clinical manifestations and may progress to severe cardiac dysfunction requiring advanced life support. This retrospective study included 78 children with clinically suspected myocarditis treated between January 2021 and December 2024. Children were stratified by left ventricular ejection fraction (LVEF) at admission and further analyzed according to the use of extracorporeal membrane oxygenation (ECMO). Children with LVEF &lt;50% more frequently presented with gastrointestinal symptoms, shock, arrhythmias, organ dysfunction, and higher rates of pediatric intensive care unit (PICU) admission and ECMO support. Left ventricular ejection fraction &lt;50%, arrhythmia, younger age, hypoalbuminemia, elevated lactate and myocardial injury biomarkers were associated with ECMO support. Reduced LVEF in pediatric myocarditis is associated with a higher risk of organ dysfunction and a greater need for advanced life support; ECMO support correlates with markers of myocardial injury and systemic hypoperfusion. These findings may help clinicians recognize high-risk patients early and guide timely escalation of life-support therapies.<\/jats:p>","DOI":"10.1177\/00099228261479244","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T11:57:56Z","timestamp":1787313476000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Characteristics of Pediatric Myocarditis Stratified by Left Ventricular Ejection Fraction and Factors Associated with ECMO Support"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-2462-0910","authenticated-orcid":false,"given":"Lingzhu","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingbo","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neonatology, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Qi","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weike","family":"Ma","sequence":"additional","affiliation":[{"name":"Pediatric Intensive Care Unit, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaozhou","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8655-7393","authenticated-orcid":false,"given":"Ping","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Shenzhen Children\u2019s Hospital, Shantou University Medical College, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.116.005306"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.4070\/kcj.2020.0108"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PCC.0000000000001363"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-22-0696"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1253\/circj.CJ-11-1032"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60648-X"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/MOP.0b013e32833924d2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v7.i5.548"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001345"},{"issue":"1","key":"e_1_3_2_11_2","first-page":"36","article-title":"Expert consensus on extracorporeal membrane oxygenation support for pediatric fulminant myocarditis","volume":"29","author":"Pediatric Group of the Extracorporeal Life Support Professional Committee of the Chinese Medical Association; Extracorporeal Life Support Committee of the Pediatric Intensive Care Branch of the Chinese Medical Association; Emergency Group of the Pediatric Branch of the Chinese Medical Association","year":"2020","unstructured":"Pediatric Group of the Extracorporeal Life Support Professional Committee of the Chinese Medical Association; Extracorporeal Life Support Committee of the Pediatric Intensive Care Branch of the Chinese Medical Association; Emergency Group of the Pediatric Branch of the Chinese Medical Association. Expert consensus on extracorporeal membrane oxygenation support for pediatric fulminant myocarditis. Chin J Emerg Med. 2020;29(1):36-42.","journal-title":"Chin J Emerg Med"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3345\/cep.2020.00836"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MAT.0000000000001431"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/2510695"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001368"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000001001"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2018.09.072"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.2115"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00605-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCHEARTFAILURE.123.010840"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2023.09.009"},{"issue":"4","key":"e_1_3_2_22_2","first-page":"391","article-title":"ACC expert consensus decision pathway on strategies and criteria for the diagnosis and management of myocarditis: a report of the American College of Cardiology solution set oversight committee","volume":"85","author":"Writing C","year":"2024","unstructured":"Writing C, Drazner MH, Bozkurt B, et al. 2024 ACC expert consensus decision pathway on strategies and criteria for the diagnosis and management of myocarditis: a report of the American College of Cardiology solution set oversight committee. J Am Coll Cardiol. 2025;85(4):391-431.","journal-title":"J Am Coll Cardiol"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac244"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2019.10.015"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2022.03.008"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00380-017-0960-0"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaccao.2025.01.020"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf192"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-017-1638-1"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.024393"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2025.08.009"}],"container-title":["Clinical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228261479244","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00099228261479244","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228261479244","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T18:01:58Z","timestamp":1787594518000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00099228261479244"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,21]]},"references-count":30,"alternative-id":["10.1177\/00099228261479244"],"URL":"https:\/\/doi.org\/10.1177\/00099228261479244","relation":{},"ISSN":["0009-9228","1938-2707"],"issn-type":[{"value":"0009-9228","type":"print"},{"value":"1938-2707","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,21]]},"article-number":"00099228261479244"}}