Abstract 9173: Neurological and Cardiac Functional Status After Extracorporeal Membrane Oxygenation in Children with Heart Disease
Bibliographic record
Abstract
Introduction: There are limited outcomes data following hospital discharge after extracorporeal membrane oxygenation (ECMO) in children with heart disease. Hypothesis: Children with heart disease who are hospital survivors of ECMO have ongoing mortality, but minimal functional residua. Methods: We reviewed data of all children with heart disease receiving venoarterial ECMO for a cardiac indication between 2001-2008. Pre-ECMO characteristics, ECMO details, complications and outcomes were abstracted from institutional databases and medical records. Univariate and multivariable analyses to determine factors associated with hospital survival and neurological outcomes using the Pediatric Cerebral Performance Category (PCPC) score were performed. Results: 184 ECMO episodes (163 patients) occurred at a median ( 25 th , 75 th %ile) age of 0.36 (0.04, 2.2) years; indications were cardiomyopathy (22%) and post-cardiotomy (66%). Cardiac arrest prompted 100 (54%) ECMO episodes in 86 patients. The median duration of CPR was 31 minutes. The median ECMO duration was 4 days. ECMO complications included intracranial hemorrhage (22%), ischemic brain injury (27%), seizures (27%), pulmonary or gastrointestinal bleeding (15%) and need for renal replacement therapy (49%). Of the total inception cohort, 63 (41%) survived to hospital discharge; 58 (36%) were alive at a median follow-up of 3.6 years with the majority (81%) having a PCPC score ≤ 2. Of the 86 patients who had cardiac arrest, 28 (33%) survived to hospital discharge; 22 (26%) were alive at a median follow-up of 3 years with the majority (81%) having a PCPC score ≤ 2. At follow-up, 55 (82%) were in pediatric NYHA Class ≤ 2 heart failure. Factors associated with hospital survival were cardiomyopathy (OR=2.2, p=0.01) and biventricular physiology (OR=1.9, p=0.006). A pre-ECMO diagnosis of cardiomyopathy was associated with a lower PCPC score at 6 months (EST: -0.24, p=0.0007), while ECMO for cardiac arrest was associated with a higher PCPC score at (EST: 0.16, p=0.008) 6 month follow-up. Conclusion: Children with heart disease who survive to hospital discharge after ECMO have ongoing early mortality; despite these concerns, survivors have good quality neurological outcome and cardiac functional status.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".