Unsuspected congenital heart disease in neonates receiving extracorporeal life support: A review of ninety-five cases from the Extracorporeal Life Support Organization Registry

doi:10.1016/S0022-3476(05)82555-7

The Journal of Pediatrics

Volume 121, Issue 1, July 1992, Pages 115-117

https://doi.org/10.1016/S0022-3476(05)82555-7 Get rights and content

The purpose of this study was to determine the frequency of patients with congenital heart disease who were given extracorporeal life support (ECLS) for respiratory failure. Underlying congenital heart disease “masked” by respiratory failure occurred in 2%. The most frequent pre-ECLS diagnosis that “masked” congenital heart disease was persistent fetal circulation. Of neonates with a pre-ECLS diagnosis of persistent fetal circulation, congenital heart disease was found in 56 (9%) of 623 patients.

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Data from all CDH neonates with congenital heart disease managed at a single pediatric tertiary care referral center between 1997 and 2011 were retrospectively analyzed.
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Although the nature of hypoxemia in CHD and PPHN is attributable to compromised pulmonary blood flow, the approach to therapeutic intervention has important differences. The consequences of suboptimal management include significant morbidity and mortality [12]. Early administration of PGE1 is probably justified when the probability of PGE1 responsive lesion in a given cohort is sufficiently high and where facilities for ready ventilation exist [15,16].
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Although the accuracy of a diagnosis of CHD and the decision to initiate PGE₁ was high, 12% of neonates with a duct-dependent CHD were transported without commencement of PGE₁. Lower thresholds for PGE₁ administration to hypoxemic neonates may potentially improve preoperative stabilization and minimize neonatal morbidity.
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Clinical and laboratory observationUnsuspected congenital heart disease in neonates receiving extracorporeal life support: A review of ninety-five cases from the Extracorporeal Life Support Organization Registry

J Pediatr Surg

J Thorac Cardiovasc Surg

Am J Cardiol

J Thorac Cardiovasc Surg

Clinical and laboratory observation
Unsuspected congenital heart disease in neonates receiving extracorporeal life support: A review of ninety-five cases from the Extracorporeal Life Support Organization Registry