Plasma Fatty Acid Levels in Children during Extracorporeal Membrane Oxygenation Support-A Pilot Study

Abstract

Plasma fatty acids levels are markedly elevated in patients with myocardial ischemic-reperfusion injury including those after cardiopulmonary bypass (CPB). High levels of fatty acids have detrimental effects on myocardial function. Extracorporeal membrane oxygenation (ECMO) is like CPB, but much longer, to provide a life-saving support for patients with cardiac arrest. We measured plasma fatty acid levels in children during ECMO support. Five children (aged .3-36 months, median 20 months) receiving venoarterial ECMO support after cardiac arrest in 2010 and 2011 were enrolled. The study was initiated at 32-56 hours after the start of ECMO support as a result of the complicated clinical scenario. Fatty acids were measured at 8-hour intervals for 1-3 days. The dosage of inotropes and vasoactive agents was recorded concurrently. The duration of ECMO ranged from 70 to 240 hours (median 177 hours). Four patients were successfully weaned off ECMO support. One died after termination of ECMO. Levels of fatty acids were elevated compared with the normal values. Overall, fatty acid levels continuously decreased over time (p