Extracorporeal Membrane Oxygenation Therapy in Children with Acute Fulminant Myocarditis

Objective: Acute fulminant myocarditis is a serious and rapidly progressive condition, when aggressive medical support is ineffective, extracorporeal membrane oxygenation (ECMO) support is considered the most effective option in adult. In order to observe the clinical effect and nursing of ECMO in children with acute fulminant myocarditis, we performed the following study. Methods and patients: Seven children with acute fulminant myocarditis, who were hospitalised at the Children's Hospital Intensive Care Unit, School of Medicine, Zhejiang University and received ECMO adjuvant therapy from February 2009 to July 2014, were analysed. Results: Six of seven patients were successfully weaned from ECMO treatment after 40-142 hours and discharged from the hospital; one patient died because of continued cardiac dysfunction and multiple organ failure. The total survival rate was 85.71% (6/7). The heart rate, blood pressure, and oxygen saturation significantly improved after initiating ECMO. During ECMO, wound haemorrhage was the most common complication result in 85.71% (6/7). Acute renal failure and haemorrhage secondary to haemolysis was observed in one patient, and hyperglycaemia happened in one patient. During the follow-up period lasting for 3 months to 5 years and 3 months, cardiac function recovered normally in the six surviving children. Conclusion: Clinical ECMO application provides effective support for the treatment of acute fulminant myocarditis in children. Timely intervention, thorough assessment and close monitoring based on nursing care, and complication prevention are the keys to ensuring successful ECMO treatment.