Evaluation of Pediatric Cardiomyopathy Patients in Pediatric Intensive Care Unit

Objective: Cardiomyopathies (CMP) are an important cause of end-stage heart failure in childhood. The study aims to evaluate the clinical features, treatments, and outcomes of the patients diagnosed with CMP followed in the pediatric intensive care unit (PICU). Materials and Methods: This retrospective study was conducted using the data of the patients followed in the PICU between January 1, 2008, and December 31, 2019. Demographic information of the patients, CMP types, informations of echocardiography and angiography, findings upon admission to the PICU, medical treatments applied, respiratory and circulatory support, cardiac transplantation status, and results were examined. Results: A total of 76 patients hospitalized with the diagnosis of CMP were included in the study. Among them, 39 (51%) patients were female. The majority (68.4%) were diagnosed with dilated CMP. The remaining patients were diagnosed with noncompaction left ventricular (LV) dilated CMP (14.5%), restrictive CMP (10.5%), hypertrophic CMP (5.3%), and noncompaction LV restrictive CMP (1.3%). Diuretics, inotropes, and invasive mechanical ventilation were used in 90.8%, 93.4%, and 75% of patients, respectively. While 43.4% (n = 33) of the patients needed extracorporeal membrane oxygenation (ECMO) support during their PICU hospitalization, 15.8% (n = 12) received LV assist device (LVAD) and 2.6% (n = 2) biventricular assist device (BiVAD) support. Heart transplantation was performed in 10 patients (13.2%). Finally, 40 (52.6%) of the patients died. Conclusion: Pediatric patients with CMP with severe heart failure require inotropes, mechanical ventilation, ECMO, LVAD, BiVAD, and heart transplantation, which are crucial for lifesaving measures, along with intensive care follow-up.