Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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The use of extracorporeal membrane oxygenation in children with acute fulminant myocarditis

  • Heinsar, Silver (Critical Care Research Group, Faculty of Medicine, University of Queensland and The Prince Charles Hospital) ;
  • Raman, Sainath (Critical Care Research Group, Faculty of Medicine, University of Queensland and The Prince Charles Hospital) ;
  • Suen, Jacky Y. (Critical Care Research Group, Faculty of Medicine, University of Queensland and The Prince Charles Hospital) ;
  • Cho, Hwa Jin (Critical Care Research Group, Faculty of Medicine, University of Queensland and The Prince Charles Hospital) ;
  • Fraser, John F. (Critical Care Research Group, Faculty of Medicine, University of Queensland and The Prince Charles Hospital)
  • Received : 2020.05.04
  • Accepted : 2020.07.02
  • Published : 2021.05.15
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Abstract

Acute fulminant myocarditis (AFM) occurs as an inflammatory response to an initial myocardial insult. Its rapid and deadly progression calls for prompt diagnosis with aggressive treatment measures. The demonstration of its excellent recovery potential has led to increasing use of mechanical circulatory support, especially extracorporeal membrane oxygenation (ECMO). Arrhythmias, organ failure, elevated cardiac biomarkers, and decreased ventricular function at presentation predict requirement for ECMO. In these patients, ECMO should be considered earlier as the clinical course of AFM can be unpredictable and can lead to rapid haemodynamic collapse. Key uncertainties that clinicians face when managing children with AFM such as timing of initiation of ECMO and left ventricular decompression need further investigation.

Keywords

Acknowledgement

Hwa Jin Cho acknowledges the support of a grant NRF-2018R1D1A1A02085975 from National Research Foundation of Korea and a grant BCRI18028 from the Chonnam National University Hospital Biomedical Research Institute. Silver Heinsar received a PhD Scholarship from The Prince Charles Hospital Foundation. Authors acknowledge Sarfaraz Rahiman and In Seok Jeong for reviewing the paper before the submission and Dr. Samia Farah, MD for the illustration, which was created with BioRender.com.

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