Extracorporeal Cardiopulmonary Resuscitation in Pediatric Cardiac Patients: A Single-center Experience

Objectives: Extracorporeal cardiopulmonary resuscitation (ECPR) has been shown to increase survival rates after in-hospital pediatric cardiac arrest. The aim of this study was to describe our experience with ECPR in pediatric cardiac patients.
Methods: We performed a retrospective analysis of our experience from a single institution with 54 patients who underwent ECPR between 2016–2024. The endpoint of the study was survival to discharge.
Results: Twenty-seven patients (50%) were female, and the median age at the time of ECPR was 5 months (IQR, 0.7–23 months). Seventeen (31.5%) of the patients were neonates, and 44 patients (81.5%) had biventricular physiology. Forty-eight patients (88.8%) underwent open chest cannulation, and 6 patients (11.2%) underwent peripheral cannulation. There were 24 survivors (44.4%) and 30 (55.6%) non-survivors after ECPR. Forty-four of the patients were postoperative (81.5%), and 23 of them survived. The survival rate in postoperative patients (52.3%) was significantly higher than in non-postoperative patients (10%) (p=0.015). Forty-five patients (83.3%) had cardiac arrest in the intensive care unit (ICU), and the survival rate was significantly higher in ICU cardiac arrest patients (51.1% vs. 11.1%, p=0.029). The survival rate without neurological sequelae was 31.4%. The median duration of ECMO support was 5 days (IQR, 2–8 days).
Conclusion: Extracorporeal cardiopulmonary resuscitation is a vital application in pediatric cardiac patients. Patients who had cardiac arrest in the ICU had better outcomes than non-ICU patients (p=0.029). Survival rates of postoperative patients were found to be better than those of non-postoperative patients (p=0.015).