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Considerations and future challenges in managing ECMO for pediatric patients

Abstract In managing ECMO, preventing thrombus formation and hemolysis is crucial. While centrifugal pumps are increasingly used in pediatric ECMO, pumps designed for low flow range are not approved in..

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ECMO for out of hospital refractory cardiac arrest in children: a retrospective multicenter analysis of a regional care program

Abstract Extracorporeal membrane oxygenation (ECMO) during cardiopulmonary resuscitation (ECPR) is a lifesaving technology that has been widely described for in-hospital cardiac arrest in children with underlying cardiac disease. However, data..

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Extracorporeal membrane oxygenation in pediatric cardiac surgery: retrospective survival analysis

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a life-saving therapeutic modality in children. Outcome is multifactorial with debates regarding predictors of weaning success and mortality. Objective To explore predictors of..

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Immunothrombotic Dysregulation in Pediatric Patients Receiving Veno-arterial ECMO After Cardiac Surgery: Insights From Platelet Activation and T Cell Immune Profiling

Abstract Background: Numerous studies have demonstrated that both cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are often associated with adverse outcomes or immune dysregulation when platelet counts decline during..

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Thrombin generation parameters provide independent information on plasma coagulation potential in pediatric patients on extracorporeal membrane oxygenation: a prospective, single-center…

Abstract Background Extracorporeal membrane oxygenation (ECMO) provides circulatory and respiratory support in pediatric patients with life-threatening organ failure but can alter coagulation. Objectives To assess the relationship between a plasma..

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Extracorporeal membrane oxygenation in children after Fontan operation

Abstract Objective To investigate the outcomes of pediatric patients requiring extracorporeal membrane oxygenation (ECMO) after the Fontan operation. Methods We conducted a retrospective cohort analysis of the Extracorporeal Life Support..

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Awake paediatric venovenous extracorporeal membrane oxygenation case report: Feasibility of PICUStars Liberation Bundles to achieve early mobilisation

Abstract Awake extracorporeal membrane oxygenation (aECMO) has emerged as a strategy to minimise physical and neurocognitive complications of a prolonged intensive care admission. However, the safety and implementation in critically..

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Safety of Delayed Venoarterial Extracorporeal Membrane Oxygenation Decannulation in Pediatric Patients

Abstract Background Optimal timing of venoarterial extracorporeal membrane oxygenation (VA-ECMO) decannulation in pediatric patients with congenital or acquired heart disease remains challenging, particularly when myocardial recovery is uncertain. Some centers..

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Brain Death Determination During VA-ECMO After Pediatric Cardiac Surgery: A Case-Based Analysis of the 2023 Unified Consensus

Abstract Background Determination of brain death/death by neurologic criteria (BD/DNC) in patients supported with extracorporeal membrane oxygenation (ECMO) is particularly challenging due to extracorporeal carbon dioxide clearance, which may interfere..

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Transseptal Access System-Assisted Atrial Flow Regulator Implantation for Pediatric Left Ventricular Decompression During VA-ECMO

Abstract Left ventricular (LV) overload is a recognized complication of venoarterial extracorporeal membrane oxygenation (VA-ECMO), but pediatric decompression remains technically challenging and poorly standardized. The atrial flow regulator (AFR) (Occlutech) is..

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Neonatal enterovirus myocarditis outcomes following extracorporeal membrane oxygenation (NEMO-ECMO): An ELSO registry analysis

Abstract Background Neonates with enterovirus myocarditis may require extracorporeal membrane oxygenation (ECMO). The contemporary prognosis and risk factors for mortality of neonates with enterovirus myocarditis supported on ECMO is unknown...

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Prostaglandin Administration and Outcomes in Children on Extracorporeal Membrane Oxygenation

Abstract Objectives Extracorporeal Membrane Oxygenation (ECMO) is associated with high risks of bleeding and clotting. While traditional anticoagulants like heparin and bivalirudin target the coagulation cascade, prostaglandins including PGE1 and PGI2 may..

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Comparative decision-making analysis of extracorporeal membrane oxygenation candidacy based on a survey of pediatric critical care fellow and attending physicians

Abstract Background: Extracorporeal membrane oxygenation (ECMO) candidacy decisions for children with respiratory failure can be variable among pediatric critical care attending physicians, and prior studies showed that baseline functional status..

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Analysis of cerebral hemodynamics in neonates receiving extracorporeal membrane oxygenation support

Abstract Background Cerebral hemodynamic disturbances are common in neonates receiving extracorporeal membrane oxygenation (ECMO), yet systematic data describing changes in cerebral hemodynamics during ECMO support remain limited. This study was..

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Current use and limitations of direct thrombin inhibitors in pediatric ECMO: A European survey

Abstract Introduction Direct thrombin inhibitors (DTIs) are an alternative to unfractionated heparin during pediatric ECMO. We aimed to describe their use and limitations across Europe. Methods Fifty-two pediatric EuroELSO centers..

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Mobile versus in-center ECMO initiation in pediatric patients: a comparative outcome study

Abstract Background ECMO is indicated for respiratory or cardiopulmonary failure despite high oxygen levels, advanced ventilation, and patient optimization, when persistent hypoxemia/hypercapnia threatens life. Aim Compare characteristics and outcomes of..

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Early Initiation of Continuous Renal Replacement Therapy in Neonatal Extracorporeal Life Support: A 17-Year Retrospective Review

Abstract Neonatal fluid management in extracorporeal life support (ECLS) is complex, with the goal of improving outcomes while preventing complications. This study evaluates the impact of early continuous renal replacement..

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Reconsidering boundaries: extracorporeal membrane oxygenation candidacy for neonates with congenital anomalies of the kidney and urinary tract

Abstract The role of extracorporeal membrane oxygenation (ECMO) in neonates with congenital anomalies of the kidney and urinary tract (CAKUT) remains one of the more contested frontiers at the intersection..

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Physiology-Mimicking Microfluidic Oxygenator with Good Hemocompatibility for In Vitro Respiratory Support of Preterm Infants

Abstract Preterm infants, especially extremely preterm infants under 28 weeks of gestation, face high mortality rates due to respiratory distress resulting from pulmonary immaturity. Conventional mechanical ventilation and extracorporeal membrane..

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Anticoagulation Changes and Biochemical Signals Preceding Hospital-Acquired Infections in Pediatric Extracorporeal Support

Abstract Hospital-acquired infection (HAI) is a major complication in pediatric patients on extracorporeal membrane oxygenation (ECMO) and continuous renal replacement therapy (CRRT). Infection detection is challenging, as traditional inflammatory markers..

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Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Cardiac Catheterization Laboratory: Incidence, Risk Scoring, and Outcomes

Abstract Pediatric patients undergoing cardiac catheterization are at risk of major adverse events, including cardiac arrest and the need for extracorporeal membrane oxygenation support. The primary aim of this study..

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Efficacy of universal genome sequencing in infant extracorporeal membrane oxygenation

Abstract Objective To evaluate the feasibility and diagnostic yield of universal genome sequencing (GS) in infants receiving extracorporeal membrane oxygenation (ECMO). Study design Prospective multicenter study across eight Children’s Hospital..

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Transfusion of blood products to neonatal and pediatric extracorporeal membrane oxygenation patients: A prospective, observational study

Abstract Study Question To describe the blood product utilization during neonatal and pediatric extracorporeal membrane oxygenation (ECMO) and to determine whether its usage correlates with clinical outcomes of bleeding, thrombosis..

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Plasma Biomarkers of Brain Injury in Critically Ill Children Receiving Extracorporeal Membrane Oxygenation

Abstract Importance  Timely identification of acute brain injury (ABI) in children receiving extracorporeal membrane oxygenation (ECMO) support is critical for early neuroprotective interventions. Objectives  To determine if elevations in plasma glial fibrillary..

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Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis

Abstract Background Survival following the Norwood procedure has improved substantially, but outcomes for the high-risk subgroup requiring postoperative extracorporeal membrane oxygenation (ECMO) remain unclear. We explored short- and intermediate-term outcomes..

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Impaired Cerebral Autoregulation in Pediatric Patients with ECMO: A Retrospective Analysis of ECMO Time Periods and Association with Neurologic Injury

Abstract Objective Neurologic injury is common in pediatric patients with extracorporeal membrane oxygenation (ECMO). Impaired cerebral autoregulation (CAR) may increase the risk of neurologic injury. We aimed to measure CAR..

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Feasibility of “Awake” Extracorporeal Membrane Oxygenation Cannulation Before Intubation in Children

Abstract When the risk of cardiopulmonary arrest during intubation is high, “awake” extracorporeal membrane oxygenation (ECMO) cannulation with sedation and a natural airway may provide hemodynamic stability and gas exchange..

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Neonatal extracorporeal membrane oxygenation outcomes according to social determinants of health

Abstract Objective To characterize relationships between social determinants of health (SDoH) and mortality among infants receiving extracorporeal membrane oxygenation (ECMO). Study design Retrospectively, we identified infants born >34weeks gestation and..

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Patterns of Multiple Organ Dysfunction in Children on Extracorporeal Membrane Oxygenation Support

Abstract We present the first characterization of multiple organ dysfunction (OD) patterns and their associations with in-hospital mortality for children on extracorporeal membrane oxygenation (ECMO). We retrospectively assessed OD for..

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Time to extracorporeal cardiopulmonary resuscitation flow and outcomes in paediatric in-hospital cardiac arrest: a 12-year single-centre study

Abstract Background Extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly used for refractory paediatric in-hospital cardiac arrest (IHCA). Although rapid initiation of extracorporeal life support (ECLS) is widely considered critical, the relative..

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