JCK-AP session 5-2 (II-JCKAP5-2)
Miscellaneous 2

[II-JCKAP5-2-1] Echocardiographic Predictors of Successful Weaning from Extracorporeal Membrane Oxygenation in Pediatrics and Congenital Heart Disease Patients

^○Hye Won Kwon¹, Jae Gun Kwak¹, Sungkyu Cho¹, Woong-Han Kim¹, Mi Kyoung Song², Sang Yun Lee², Gi Beom Kim², Eun Jung Bae² (1.Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, 2.Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul)

Keywords:Extracorporeal membrane oxygenation, Weaning, Echocardiography

Objective: This study aimed to identify specific echocardiographic parameters associated with successful extracorporeal membrane oxygenation (ECMO) weaning in pediatric and congenital heart disease patients.Method: A retrospective study was conducted on pediatric and congenital heart disease patients who underwent venoarterial ECMO from March 2018 to September 2023 in a single tertiary center to investigate clinical information and echocardiographic parameters for predicting ECMO weaning.Results: Venoarterial ECMO was inserted in 46 cases, and successful weaning was achieved in 31 cases. Successful weaning correlated with higher systolic pressure and pulse pressure, lower central venous pressure, lactate levels, and inotropic equivalents. In the group where ECMO weaning was successful, the left ventricular ejection fraction was higher (50.9 ± 16.4 % versus 27.3 ± 18.7 %, p-value < 0.001) and the velocity time integral measured at the left ventricular outflow tract was significantly higher (12.3 ± 8.0 cm versus 4.1 ± 3.6 cm, p-value ± 0.001) compared to the group where weaning failed. The cutoff values for predicting successful ECMO weaning were a left ventricular ejection fraction of 43% (sensitivity 0.742, specificity 0.867) and a left ventricular outflow tract velocity time integral of 4.45 cm (sensitivity 0.920, specificity 0.667).Conclusions: Echocardiographic parameters are valuable in predicting successful ECMO weaning in pediatric and congenital heart disease patients, aiding clinicians in decision-making.