- Author: Seul A Choi, Reverien Habimana, Matteo Di Nardo, Insu Choi, In Seok Jeong, Hwa Jin Cho
- Date: 2023/09/01
- Journal: ASAIO Journal;69(Suppl 3);59
- PMID:
- PMCID:
- DOI: 10.1097/01.mat.0000990948.03852.07
Abstract
Objective: Aggressive and robust treatments such as extracorporeal membrane oxygenation (ECMO) are warranted in patients with Acute fulminant myocarditis (AFM) because of favorable long-term prognosis with complete recovery of left ventricle function is reported. We conducted a systematic review and meta-analysis to assess the survival and the clinical outcomes of acute fulminant myocarditis in neonates and children requiring ECMO.
Methods: A search of the PubMed, Embase, and Cochrane databases was conducted for studies published from inception to May 1, 2022, Studies include a population of children and neonates who were admitted for AFM and underwent ECMO. The primary outcome was survival to hospital discharge.
Results: Ten studies were included in this meta-analysis, with a total of 788 patients. The overall pooled estimate of survival was 67% (95% CI 59 to 74%, p < 0.01, I° = 57%) (Fig. 1). Meta-regression found that mean age and mean ECMO duration had no significant association with survival. When analyzing the trend of survival rates based on the years of inclusion studies, the survival rate did not increase (β: 0.085, 95%CI: – 0.000 to 0.171, p= 0.026) (Fig. 2).
Conclusion: The use of ECMO in neonates and children with AFM has a survival rate of 67%. Despite the aggressive nature and severity of AFM, ECMO deployment might be crucial for better outcomes. In more recent periods, survival was improved.