Objective: Data on the management and outcomes of acute myocarditis treated with extracorporeal membrane oxygenation (ECMO) among low- and middle-income countries are limited. This study aimed to determine the short-term outcomes and also identify factors associated with ECMO use among children with acute myocarditis at a tertiary children's hospital in Vietnam.

Methods: A single-center, retrospective observational study was conducted between January 2016 and February 2021. Pediatric patients with acute myocarditis, aged 1 month to 16 years, were included.

Results: In total, 54 patients (male, 46%; median age, 7 years) with acute myocarditis were included; 37 of them received ECMO support. Thirty percent (16/54) of the patients died, and 12 of them received ECMO. Laboratory variables that differed between survivors and non-survivors included median left ventricular ejection fraction (LVEF) at 48 h (42 vs. 25%; p = 0.001), platelet count (304 g/L [interquartile range (IQR): 243–271] vs. 219 g/L [IQR: 167–297]; p = 0.014), and protein (60 g/dl [IQR: 54–69] vs. 55 [IQR: 50–58]; p = 0.025). Among patients who received ECMO, compared with the survivors, non-survivors had a low LVEF at 48 h (odds ratio (OR), 0.8; 95% confidence interval (CI): 0.6–0.9; p = 0.006) and high vasoactive-inotropic score (OR, 1.0; 95% CI: 1.0–1.0; p = 0.038) and lactate (OR, 2.8; 95% CI, 1.2–6.1; p = 0.013) at 24 h post-ECMO.

Conclusions: The case fatality rate among children with acute myocarditis was 30 and 32% among patients requiring ECMO support. Arrhythmia was an indicator for ECMO in patients with cardiogenic shock.

客观的：在低收入和中等收入国家，体外膜肺氧合 (ECMO) 治疗急性心肌炎的管理和结果数据有限。本研究旨在确定越南一家三级儿童医院的急性心肌炎患儿的短期结果，并确定与 ECMO 使用相关的因素。

方法： 在 2016 年 1 月至 2021 年 2 月期间进行了一项单中心、回顾性观察性研究。纳入了年龄为 1 个月至 16 岁的儿童急性心肌炎患者。

结果：共纳入 54 名急性心肌炎患者（男性，46%；中位年龄，7 岁）；其中37人获得ECMO支持。百分之三十 (16/54) 的患者死亡，其中 12 人接受了 ECMO。存活者和非存活者之间不同的实验室变量包括 48 小时时的中位左心室射血分数 (LVEF)（42% vs. 25%；p = 0.001)，血小板计数（304 g/L [四分位距 (IQR)：243–271] 对比 219 g/L [IQR：167–297]； p = 0.014）和蛋白质（60 g/dl [IQR: 54–69] vs. 55 [IQR: 50–58]； p= 0.025）。在接受 ECMO 的患者中，与存活者相比，非存活者在 48 小时时的 LVEF 较低（优势比（OR），0.8；95% 置信区间（CI）：0.6-0.9；p = 0.006) 和高血管活性肌力评分（OR，1.0；95% CI：1.0–1.0； p = 0.038) 和乳酸 (OR, 2.8; 95% CI, 1.2–6.1; p = 0.013) 在 ECMO 后 24 小时。

结论：在需要 ECMO 支持的患者中，急性心肌炎患儿的病死率分别为 30% 和 32%。心律失常是心源性休克患者 ECMO 的指标。