Abstraktband als pdf - DGPK-Deutsche Gesellschaft für Pädiatrische ...

44. Jahrestagung der Deutschen Gesellschaft für Pädiatrische Kardiologie
– Abstracts –
11
Antikoagulation
V28 – V29
Abstractvorträge Forschung
V30 – V34
Extracorporal membrane oxygenation (ECMO)
in pediatric patients after cardiac surgery –
V28
A single centre 12-year experience
T.Logeswaran (1), Thul (1), L. Fink (1), A.Hahn (2) J.Bauer (1), ,
H.Akintürk (3),K.Valeske (3), D.Schranz (1)Kinderherzzentrum Gießen
(1), Neuropädiatrie Gießen (2), Kinderherzchirurgie Gießen (3)
Introduction: The aim of this study was to analyze the overall and neurological
outcomes of pediatric patients requiring ECMO after cardiac surgery
in our institution. Methods: We retrospectively analyzed the data of
all children who received ECMO due to intraoperative heart failure in our
centre between 2000 and 2012. Results: 70 patients had to be placed on
ECMO after surgery. Median age at start of therapy was 3 months (range
3 days to 10 years). 44 patients (63%) underwent biventricular repair,
21 (30%) univentricular repair, and 5 (7%) orthotopic heart transplantation.
Indication for ECMO was weaning failure in 22 subjects (31%), low
cardiac output in19 (27%), isolated left ventricular failure in 9 (13%),
isolated right ventricular failure in 8 (11%), pulmonary hypertension in
9 (13%), and malignant arrhythmia in 1 (1%) patient. Median ECMO
time was 5 (range 1-25) days. 22 patients (31%) died, 15 deceased during
ECMO and 7 after decannulation. Persistent neurological deficits and/or
unequivocal neuroradiological abnormalities were detected in 17 patients
(24%). Comparing risk factors between ECMO survivors and non-survivors
by univariate statistical analysis revealed that prolonged duration of
ECMO (p=.001), univentricular repair (p=.006), weaning failure (p=.01),
and cardiopulmonary resuscitation during ECMO (p=.001) were negative
outcome predictors. Neurological complications occurred in 64% of nonsurvivors
and in 6% of survivors.
Conclusions: The overall survival rate of children undergoing ECMO after
cardiac surgery is good. Neurological complications are frequent and
associated with higher mortality. The relatively high proportion of neurological
problems should prompt careful surveillance and should lead to
early initiation of special needs if indicated.
A LQTS phenotype and reduced baroreceptor reflex
sensitivity in mice deficient for the potassium channel V30
TASK-1 - results from in vivo electrophysiological studies
B. Donner (1), S. Petric (1), L. Clasen (1), C. van Weßel (1), Z. Ding (2),
K.G. Schmidt (1) (1) Dept. of Pediatric Cardiology, (2) Cardiovascular
Physiology, University of Duesseldorf
Background: TASK-1 is mainly expressed in heart and brain. We have
shown that TASK-1 -/- mice have a prolonged QT interval in ECGs in
sedation (ketamine). Heart rate variability was significantly impaired in
TASK-1 -/- mice. Although TASK-1 -/- mice showed a significant prolongation
of action potential duration in isolated hearts the electrophysiological
role in vivo is unknown. Here, we analysed rate corrected QT intervals
(QT c
) in wake mice and after different drugs, evaluated the baroreceptor
reflex sensitivity by analyzing heart rate turbulence (HRT) and characterized
TASK-1 -/- mice by in vivo electrical stimulation (ES).
Methods: ECGs using different sedating drugs (avertin, pentobarbital,
isoflurane) and telemetric ECGs by implanted transmitters were analysed.
QT c
intervals were calculated using different correction formulas.
HRT parameters were determined after paced ventricular extrasystole
(VES). Programmed ES recorded conduction velocity, refractory times
and cardiac vulnerability by burst stimulation (before and after isoprenaline).
Results: Telemetric ECGs showed a significantly prolonged QT c
interval
in TASK-1 -/- mice (TASK-1 +/+ 43±3ms vs. TASK-1 -/- 49±5ms, n=6,
p