Extracorporeal membrane oxygenation for the support of pediatric patients with acute fulminant myocarditis

Abstract

Acute fulminant myocarditis, is a severe, rapidly progressive disease. Theclinical outcomes of children with severe acute myocarditis who are resistto medical treatment is not well known. We studied the clinical courses ofpatients with acute fulminant myocarditis supported by extracorporealmembrane oxygenation (ECMO). We performed a retrospective chart reviewof six children with acute fulminant myocarditis who were treated with ECMO.Demographic information, clinical and vital signs, as well as laboratory resultswere investigated. The median age of 63 months (13-140 months), the meanECMO duration was 164 hours (79-402 hours), and median intensive careunit stay was 24 days. The most common symptoms were chest pain (66%)and fever (66%). Severe arrhythmia were seen in two patients. One patientreceived extracorporeal cardiopulmonary resuscitation. In two patients, rightfemoral arteries and right femoral veins were used, in others, right commoncarotid artery and right internal jugular veins were used. Five patients (83.3%) survived to discharge. ECMO can be used effectively in pediatric patientswith acute fulminant myocarditis to support the circulation while awaitingmyocardial recovery. Timely use of ECMO can improve the survival rate andmay be associated with better outcomes.