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Cardiology691 papers

Neonatal cardiac failure

Last edited: 4/23/2026

Overview

Neonatal cardiac failure refers to the inability of the neonatal heart to pump sufficient blood to meet metabolic demands, often due to congenital heart defects, cardiomyopathy, or complications from critical illness 44.

Diagnosis

  • Clinical Presentation: Tachycardia, hypotension, poor perfusion, and signs of respiratory distress 44.
  • Diagnostic Tests: Echocardiography to assess cardiac function and structure, blood gas analysis for metabolic status, and biomarkers like cardiac troponin for myocardial injury 718.
  • Grading: Utilize clinical scoring systems or specific criteria from neonatal ECMO guidelines for severity stratification 24.
  • Management

  • First-Line Treatments:
  • - Supportive Care: Fluid management, inotropic support (e.g., dopamine, epinephrine) 265. - Mechanical Support: Venoarterial ECMO for refractory cases 1826.
  • Adjunctive Treatments:
  • - Inotropic Agents: Milrinone or levosimendan for inotropic support 40. - Weaning Protocols: Systematic approach to weaning from ECMO, monitoring hemodynamic parameters 265.

    Special Populations

  • Pediatrics: Neonates often require ECMO support for severe cardiac failure; careful monitoring of fluid status and renal function is crucial 177.
  • Comorbidities: Acute kidney injury and fluid overload significantly impact outcomes; management strategies should address these comorbidities 17.
  • Key Recommendations

  • Initiate ECMO Early for Refractory Cases: Use ECMO in neonates with refractory cardiac failure to improve hemodynamic stability (Evidence: Moderate 1826).
  • Monitor Fluid Status and Renal Function: Closely monitor for signs of fluid overload and acute kidney injury, as these factors adversely affect outcomes (Evidence: Moderate 17).
  • Systematic Weaning Protocols: Employ structured protocols for weaning from ECMO to reduce complications and improve survival rates (Evidence: Weak 26).
  • Consider Inotropic Support: Utilize inotropic agents like levosimendan or milrinone judiciously to support cardiac function (Evidence: Moderate 40).
  • Regular Echocardiographic Monitoring: Continuously assess cardiac function and structural changes via echocardiography to guide treatment adjustments (Evidence: Expert opinion 7).
  • References

    Showing 100 most recent of 318 indexed papers.

    1 Batchelor RJ, Hodgson CL, Lankaputhra M, Burrell A, Orosz J, Coull J et al.. Sex differences in venoarterial extracorporeal membrane oxygenation utilisation and clinical outcomes in Australia. Journal of critical care 2026. link 2 Duraisamy P, Nandakumar A, Kelamangalam NeelakantaKurup H, Rahul A, Sujatha R, Venugopal A et al.. Right atrial thrombus in neonates following hyperosmolar glucose infusion: A case series. Journal of neonatal-perinatal medicine 2026. link 3 Defilippis EM, Donald E, Cho L, Sauer A, Maning J, Blumer V et al.. Association of Double-Blind Reviews With Increases in Women as First Authors: An Initial Report From the Journal of Cardiac Failure. Journal of cardiac failure 2025. link 4 Shirakabe A, Matsushita M, Shigihara S, Nishigoori S, Sawatani T, Tani K et al.. Age-specific differences of Impella support in Japanese patients: The Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events. Journal of cardiology 2025. link 5 Hsu HR, Sekhar P, Grover J, Tian DH, Downey C, Maudlin B et al.. Predictors of successful weaning from veno-arterial extracorporeal membrane oxygenation (V-A ECMO): A systematic review and meta-analysis. PloS one 2025. link 6 Poyanmehr R, Hanke JS, Boethig D, Merzah AS, Karsten J, Frank P et al.. Validity and Accuracy of the Derived Left Ventricular End-Diastolic Pressure in Impella 5.5. Circulation. Heart failure 2025. link 7 Zhang XJ, Liu YY, Wang H, Hong XY. Extracorporeal membrane oxygenation for Chinese neonates with severe respiratory and cardiac failure. Journal of cardiothoracic surgery 2025. link 8 Saemann L, Stiller M, Willsch J, Schultze T, Matin M, Veres G et al.. First experience with the new extracorporeal membrane oxygenation system Colibrì. Artificial organs 2024. link 9 Mathur A, Sharma C, Shukla V, Agrawal Y. Estimation of time since death using cardiac troponin I in case of death due to asphyxia and cardiotoxicity of acebutolol. Forensic science, medicine, and pathology 2024. link 10 Liu X, Wen Y, Lu Y. Targeting MuRF1 to Combat Skeletal Muscle Wasting in Cardiac Cachexia: Mechanisms and Therapeutic Prospects. Medical science monitor : international medical journal of experimental and clinical research 2024. link 11 Finnan MJ, Chi D, Chiang SN, Vader JM, Cabrera NL, Kells AF et al.. Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score. Journal of the American College of Surgeons 2024. link 12 Dietrich M, Weilbacher F, Katzenschlager S, Weigand MA, Popp E. Severe trauma associated cardiac failure. Scandinavian journal of trauma, resuscitation and emergency medicine 2024. link 13 Kwon JH, Bentley D, Cevasco M, Blumer V, Kanwar MK, Silvestry SC et al.. Patient Characteristics and Early Clinical Outcomes With Impella 5.5: A Systematic Review and Meta-Analysis. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2024. link 14 van Thiel BS, de Boer M, Ridwan Y, de Kleijnen MGJ, van Vliet N, van der Linden J et al.. Hybrid Molecular and Functional Micro-CT Imaging Reveals Increased Myocardial Apoptosis Preceding Cardiac Failure in Progeroid Ercc1 Mice. Molecular imaging and biology 2024. link 15 Dominguez JH, Xie D, Kelly KJ. Cardiac effects of renal ischemia. American journal of physiology. Renal physiology 2023. link 16 Goldschmidt E, Schafer K, Hariri N, Seiwert A, Lurie F. Salvage of a megafistula causing high-output cardiac failure in a young adult with aneurysmorrhaphy and banding. The journal of vascular access 2023. link 17 Pettit KA, Selewski DT, Askenazi DJ, Basu RK, Bridges BC, Cooper DS et al.. Synergistic association of fluid overload and acute kidney injury on outcomes in pediatric cardiac ECMO: a retrospective analysis of the KIDMO database. Pediatric nephrology (Berlin, Germany) 2023. link 18 Elizalde PS, Chaud GJ, Gundelach J, Gaete B, Durand M, Cuadra I et al.. Extracorporeal Membrane Oxygenation Uses in Refractory Cardiogenic Shock After Open-Heart Surgery. Brazilian journal of cardiovascular surgery 2023. link 19 Zachoval CF, Sedaghat A, Oezkur M, Tiyerili V, Becher MU, Sinning JM et al.. Feasibility and Safety of an 8 F Angioseal. Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists 2022. link 20 Zhang Y, Wu X, Wang Y, Liu H, Liu GM. The hemodynamics and blood trauma in axial blood pump under different operating models. Artificial organs 2022. link 21 Kuroda H, Nakano Y, Machida D. Successful combination treatment with transcatheter balloon atrioseptostomy and bilateral pulmonary artery banding in a collapsed preterm neonate. Cardiology in the young 2021. link 22 Jothinathan M, Gan YY, Qayyum A. Intestinal adaptation in fluid restricted cardiac failure following extensive bowel resection. The Medical journal of Malaysia 2021. link 23 Lusty A, Siemens DR, Tohidi M, Whitehead M, Tranmer J, Nickel JC. Cardiac Failure Associated with Medical Therapy of Benign Prostatic Hyperplasia: A Population Based Study. The Journal of urology 2021. link 24 Brown G, Moynihan KM, Deatrick KB, Hoskote A, Sandhu HS, Aganga D et al.. Extracorporeal Life Support Organization (ELSO): Guidelines for Pediatric Cardiac Failure. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2021. link 25 Butragueño Laiseca L, Estepa Pedregosa L, Sánchez Galindo AC, Santiago Lozano MJ. Hemolysis and methemoglobinemia in a child with left ventricular assist Levitronix PediMag. The International journal of artificial organs 2021. link 26 Mørk SR, Frederiksen CA, Nielsen RR, Lichscheidt E, Christensen S, Greisen JR et al.. A systematic approach to weaning from extracorporeal membrane oxygenation in patients with refractory cardiac failure. Acta anaesthesiologica Scandinavica 2021. link 27 Groves A. The Future of Cardiac Ultrasound in the Neonatal Intensive Care Unit. Clinics in perinatology 2020. link 28 Simmons MA, Otero-Luna A, Redmond B, Fahey J, Beach C, Bruno C et al.. Neonatal Cardiac Emergencies: A Multidisciplinary Simulation Curriculum for Neonatology and Pediatric Cardiology Fellows. MedEdPORTAL : the journal of teaching and learning resources 2020. link 29 Fuster V. Editor-in-Chief's Top Picks From 2019. Journal of the American College of Cardiology 2020. link 30 Perino J, Mottal N, Bohbot Y, Servant V, Berroneau A, Poustis P et al.. Cardiac failure in patients treated with azacitidine, a pyrimidine analogue: Case reports and disproportionality analyses in Vigibase. British journal of clinical pharmacology 2020. link 31 Assmann A, Boeken U, Klotz S, Harringer W, Beckmann A. Organization and Application of ECLS Therapy-A Nationwide Survey in German Cardiosurgical Departments. The Thoracic and cardiovascular surgeon 2019. link 32 Iwagaki S, Takahashi Y, Chiaki R, Asai K, Matsui M, Katsura D. Case of resuscitation from cardiac failure by intrauterine transfusion after single fetal death in monochorionic twin pregnancy. The journal of obstetrics and gynaecology research 2019. link 33 Bearl DW, Jaquiss RDB, Vesel TP. Indications and Outcomes for Temporary Mechanical Circulatory Support in Pediatric Patients with Cardiac Failure. ASAIO journal (American Society for Artificial Internal Organs : 1992) 2019. link 34 Coyan GN, Zinn MD, West SC, Sharma MS. Heart Transplantation from Biventricular Support in Infant with Novel SMYD1 Mutation. Pediatric cardiology 2019. link 35 Letchumanan I, Md Arshad MK, Balakrishnan SR, Gopinath SCB. Gold-nanorod enhances dielectric voltammetry detection of c-reactive protein: A predictive strategy for cardiac failure. Biosensors & bioelectronics 2019. link 36 Anirudhan TS, Nair AS, S S G. The role of biopolymer matrix films derived from carboxymethyl cellulose, sodium alginate and polyvinyl alcohol on the sustained transdermal release of diltiazem. International journal of biological macromolecules 2018. link 37 Bosboom JJ, Klanderman RB, Zijp M, Hollmann MW, Veelo DP, Binnekade JM et al.. Incidence, risk factors, and outcome of transfusion-associated circulatory overload in a mixed intensive care unit population: a nested case-control study. Transfusion 2018. link 38 Lee HE, Yi ES, Rabatin JT, Bohman JK, Roden AC. Histopathologic Findings in Lungs of Patients Treated With Extracorporeal Membrane Oxygenation. Chest 2018. link 39 Marcuschamer IA, Abelow A, Kornowski R. The evolving role of percutaneous ventricular assist devices in high-risk cardiac patients. Coronary artery disease 2018. link 40 Jacky A, Rudiger A, Krüger B, Wilhelm MJ, Paal S, Seifert B et al.. Comparison of Levosimendan and Milrinone for ECLS Weaning in Patients After Cardiac Surgery-A Retrospective Before-and-After Study. Journal of cardiothoracic and vascular anesthesia 2018. link 41 Sabah SA, Moon JC, Jenkins-Jones S, Morgan CL, Currie CJ, Wilkinson JM et al.. The risk of cardiac failure following metal-on-metal hip arthroplasty. The bone & joint journal 2018. link 42 Stevens MC, Callaghan FM, Forrest P, Bannon PG, Grieve SM. A computational framework for adjusting flow during peripheral extracorporeal membrane oxygenation to reduce differential hypoxia. Journal of biomechanics 2018. link 43 Abrams D, Garan AR, Abdelbary A, Bacchetta M, Bartlett RH, Beck J et al.. Position paper for the organization of ECMO programs for cardiac failure in adults. Intensive care medicine 2018. link 44 Platt JL, West LJ, Chinnock RE, Cascalho M. Toward a solution for cardiac failure in the newborn. Xenotransplantation 2018. link 45 Rodriguez ML, Maharajh G. Long venous cannula on the arterial position for VA-ECMO. Perfusion 2018. link 46 Patras de Campaigno E, Bondon-Guitton E, Laurent G, Montastruc F, Montastruc JL, Lapeyre-Mestre M et al.. Identification of cellular targets involved in cardiac failure caused by PKI in oncology: an approach combining pharmacovigilance and pharmacodynamics. British journal of clinical pharmacology 2017. link 47 Nagpal AD, Singal RK, Arora RC, Lamarche Y. Temporary Mechanical Circulatory Support in Cardiac Critical Care: A State of the Art Review and Algorithm for Device Selection. The Canadian journal of cardiology 2017. link 48 Chara K, Baccouche N, Turki O, Regaig K, Chaari A, Bahloul M et al.. A rare complication of viper envenomation: cardiac failure. A case report. Medecine et sante tropicales 2017. link 49 Abbott TEF, Minto G, Lee AM, Pearse RM, Ackland GL. Elevated preoperative heart rate is associated with cardiopulmonary and autonomic impairment in high-risk surgical patients. British journal of anaesthesia 2017. link 50 Vilppu H, Mikkilä-Erdmann M, Södervik I, Österholm-Matikainen E. Exploring eye movements of experienced and novice readers of medical texts concerning the cardiovascular system in making a diagnosis. Anatomical sciences education 2017. link 51 Tuomainen T, Tavi P. The role of cardiac energy metabolism in cardiac hypertrophy and failure. Experimental cell research 2017. link 52 Lehle K, Lubnow M, Philipp A, Foltan M, Zeman F, Zausig Y et al.. Prevalence of hemolysis and metabolic acidosis in patients with circulatory failure supported with extracorporeal life support: a marker for survival?. European journal of heart failure 2017. link 53 Warren JS, Oka SI, Zablocki D, Sadoshima J. Metabolic reprogramming via PPARα signaling in cardiac hypertrophy and failure: From metabolomics to epigenetics. American journal of physiology. Heart and circulatory physiology 2017. link 54 Kirk R, Peng E, Woods A, Flett J, Hewitt T, Griselli M et al.. Successful HeartWare Bridge to Recovery in a 3-Year Old: A Game Changer?. The Annals of thoracic surgery 2016. link 55 Itoh H, Ichiba S, Ujike Y, Douguchi T, Obata H, Inamori S et al.. Effect of the Pulsatile Extracorporeal Membrane Oxygenation on Hemodynamic Energy and Systemic Microcirculation in a Piglet Model of Acute Cardiac Failure. Artificial organs 2016. link 56 Cossette SM, Bhute VJ, Bao X, Harmann LM, Horswill MA, Sinha I et al.. Sucrose Nonfermenting-Related Kinase Enzyme-Mediated Rho-Associated Kinase Signaling is Responsible for Cardiac Function. Circulation. Cardiovascular genetics 2016. link 57 Santacruz L, Jacobs DO. Structural correlates of the creatine transporter function regulation: the undiscovered country. Amino acids 2016. link 58 Sznycer-Taub NR, Lowery R, Yu S, Owens ST, Hirsch-Romano JC, Owens GE. Hyperoxia Is Associated With Poor Outcomes in Pediatric Cardiac Patients Supported on Venoarterial Extracorporeal Membrane Oxygenation. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies 2016. link 59 Bourquelot P. Access flow reduction for cardiac failure. The journal of vascular access 2016. link 60 Melhem NZ, Yadav P, Stronach L, Hothi DK. Intensified home haemodialysis for managing severe cardiac failure. Pediatric nephrology (Berlin, Germany) 2015. link 61 Chavez J, Bortolotto SJ, Paulson M, Huntley N, Sullivan B, Babu A. Promotion of progressive mobility activities with ventricular assist and extracorporeal membrane oxygenation devices in a cardiothoracic intensive care unit. Dimensions of critical care nursing : DCCN 2015. link 62 Fukushima S, Miyagawa S, Sakai Y, Sawa Y. A sustained-release drug-delivery system of synthetic prostacyclin agonist, ONO-1301SR: a new reagent to enhance cardiac tissue salvage and/or regeneration in the damaged heart. Heart failure reviews 2015. link 63 Mittal M, Radhakrishnan M, UmamaheswaraRao GS. Management of catecholamine-induced stunned myocardium--a case report. Journal of clinical anesthesia 2015. link 64 McKenna M, Clark SC. Palliative care in cardiopulmonary transplantation. BMJ supportive & palliative care 2015. link 65 Greco CM, Condorelli G. Epigenetic modifications and noncoding RNAs in cardiac hypertrophy and failure. Nature reviews. Cardiology 2015. link 66 Bollini S, Riley PR, Smart N. Thymosin β4: multiple functions in protection, repair and regeneration of the mammalian heart. Expert opinion on biological therapy 2015. link 67 Sandrio S, Springer W, Karck M, Gorenflo M, Weymann A, Ruhparwar A et al.. Extracorporeal life support with an integrated left ventricular vent in children with a low cardiac output. Cardiology in the young 2014. link 68 Jang HR, Wark AW, Baek SH, Chung BH, Lee HJ. Ultrasensitive and ultrawide range detection of a cardiac biomarker on a surface plasmon resonance platform. Analytical chemistry 2014. link 69 Dimas VV, Murthy R, Guleserian KJ. Utilization of the Impella 2.5 micro-axial pump in children for acute circulatory support. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions 2014. link 70 Garrido JM, Ferreiro A, Samaranch N, Salido L, García-Andrade I. Interventricular septal rupture after transcatheter aortic valve implantation: surgical and perioperative management. Journal of cardiac surgery 2014. link 71 Guttendorf J, Boujoukos AJ, Ren D, Rosenzweig MQ, Hravnak M. Discharge outcome in adults treated with extracorporeal membrane oxygenation. American journal of critical care : an official publication, American Association of Critical-Care Nurses 2014. link 72 Steinberg C, Sarrazin JF, Philippon F, Champagne J, Bouchard MA, Molin F et al.. Longitudinal follow-up of Riata leads reveals high annual incidence of new conductor externalization and electrical failure. Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing 2014. link 73 Biočina B, Petričević M, Belina D, Gašparović H, Svetina L, Konosić S et al.. Results of extracorporeal life support implementation in routine clinical practice: single center experience. Croatian medical journal 2014. link 74 Baeeri M, Shariatpanahi M, Baghaei A, Ghasemi-Niri SF, Mohammadi H, Mohammadirad A et al.. On the benefit of magnetic magnesium nanocarrier in cardiovascular toxicity of aluminum phosphide. Toxicology and industrial health 2013. link 75 Slottosch I, Liakopoulos O, Kuhn E, Deppe AC, Scherner M, Madershahian N et al.. Outcomes after peripheral extracorporeal membrane oxygenation therapy for postcardiotomy cardiogenic shock: a single-center experience. 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    Original source

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      Sex differences in venoarterial extracorporeal membrane oxygenation utilisation and clinical outcomes in Australia.Batchelor RJ, Hodgson CL, Lankaputhra M, Burrell A, Orosz J, Coull J et al. Journal of critical care (2026)
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      Validity and Accuracy of the Derived Left Ventricular End-Diastolic Pressure in Impella 5.5.Poyanmehr R, Hanke JS, Boethig D, Merzah AS, Karsten J, Frank P et al. Circulation. Heart failure (2025)
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      Extracorporeal membrane oxygenation for Chinese neonates with severe respiratory and cardiac failure.Zhang XJ, Liu YY, Wang H, Hong XY Journal of cardiothoracic surgery (2025)
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      First experience with the new extracorporeal membrane oxygenation system Colibrì.Saemann L, Stiller M, Willsch J, Schultze T, Matin M, Veres G et al. Artificial organs (2024)
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      Estimation of time since death using cardiac troponin I in case of death due to asphyxia and cardiotoxicity of acebutolol.Mathur A, Sharma C, Shukla V, Agrawal Y Forensic science, medicine, and pathology (2024)
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      Targeting MuRF1 to Combat Skeletal Muscle Wasting in Cardiac Cachexia: Mechanisms and Therapeutic Prospects.Liu X, Wen Y, Lu Y Medical science monitor : international medical journal of experimental and clinical research (2024)
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      Escalating Surgical Treatment for Left Ventricular Assist Device Infection and Expected Mortality: Clinical Risk Prediction Score.Finnan MJ, Chi D, Chiang SN, Vader JM, Cabrera NL, Kells AF et al. Journal of the American College of Surgeons (2024)
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      Hybrid Molecular and Functional Micro-CT Imaging Reveals Increased Myocardial Apoptosis Preceding Cardiac Failure in Progeroid Ercc1 Mice.van Thiel BS, de Boer M, Ridwan Y, de Kleijnen MGJ, van Vliet N, van der Linden J et al. Molecular imaging and biology (2024)
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      Synergistic association of fluid overload and acute kidney injury on outcomes in pediatric cardiac ECMO: a retrospective analysis of the KIDMO database.Pettit KA, Selewski DT, Askenazi DJ, Basu RK, Bridges BC, Cooper DS et al. Pediatric nephrology (Berlin, Germany) (2023)
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