article · Journal of Cardiothoracic Surgery
A retrospective review of thirty paediatric patients with surgically corrected congenital heart disease examined factors affecting extracorporeal membrane oxygenation, known as ECMO, outcomes. The patients, aged between fifteen days and twelve years, received ECMO support lasting between one and fifteen days, with most initiating support on day zero. Successful weaning was achieved in over half of the cohort, while overall mortality reached nearly forty-seven per cent. Observed complications included renal injury, neurological problems, and wound infections. Residual cardiac lesions and ECMO-related complications significantly correlated with weaning failure and mortality. Additionally, complex surgery and delayed ECMO initiation were linked to extended support duration. The findings highlight that timely ECMO initiation alongside the management of residual cardiac defects may help reduce complications and increase survival rates in paediatric surgical care.
Extracorporeal membrane oxygenation provides vital life support for critically ill children following complex heart surgery, yet mortality and complication rates remain substantial. Identifying the clinical factors that lead to treatment failure, such as surgical residual lesions and delayed device initiation, enables intensive care teams to optimise the timing of interventions, address correctable defects promptly, and potentially enhance survival outcomes in vulnerable paediatric populations.
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Extracorporeal membrane oxygenation (ECMO) is a life-saving therapeutic modality in children. Outcome is multifactorial with debates regarding predictors of weaning success and mortality. To explore predictors of ECMO outcome in children with surgically corrected congenital heart disease (CHD). This single-center retrospective cohort study included children with operated CHD who were admitted to a tertiary-care cardiac center in Saudi Arabia during 2022–2025. Demographic data, clinical characteristics, as well as operative and ECMO details were recorded. Predictors of weaning failure and overall mortality during follow-up were analyzed. Thirty children aged 15 days to 12.8 years were included. ECMO connection was applied in day zero in 23 patients (76.6%). ECMO duration ranged between 1 and 15 days. Successful ECMO weaning was achieved in 56.7%. ECMO complication included renal injury in 36.7%, neurological complications in 16.7% and wound infection in 10%. The overall mortality rate was 46.7%. Residual cardiac lesions (OR 20; 95%CI:2.037–196.37 and OR 25.6; 95%CI:2.544-257.566) and ECMO complication (OR 5.4; 95%CI:1.12-26.044 and OR 7.5.6; 95%CI:1.484–37.905) were associated with ECMO failure and mortality during follow-up. Residual cardiac lesions and ECMO-related complications were associated with poor outcome in children with surgically corrected CHD who require ECMO. The complexity of cardiac surgery and delayed initiation of ECMO are associated with prolonged ECMO stay duration. Proper timing of ECMO Initiation may reduce complications and improve survival.
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DOI: 10.1186/s13019-026-04654-0
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