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A Multicenter Survey of Extracorporeal Membrane Oxygenation Decision-Making Among Pediatric Cardiac ICUs

Abstract Background Extracorporeal membrane oxygenation (ECMO) represents one of the most ethically challenging and clinically complex therapies used in pediatric critical care. Despite limited guidance and substantial practice variability, center-level..

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Quantitative Electroencephalography Correlates With Acute Neurologic Events in Extracorporeal Membrane Oxygenation: A Pediatric Case Series

Abstract Extracorporeal membrane oxygenation (ECMO) is associated with a high risk of neurologic injury in pediatric patients, and early detection of injury is often challenging because the clinical examination is..

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Extracorporeal Membrane Oxygenation Outside the Operating Room in Neonates and Infants

Abstract Objectives Long-term outcomes of emergent extracorporeal membrane oxygenation (ECMO) initiated outside the operating room remain poorly defined. We evaluated long-term outcomes after emergent ECMO support outside the operating room..

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Pseudo-Heparin Resistance in a Child on Extracorporeal Membrane Oxygenation

Abstract We read with interest the editorial by Bolliger et al. on heparin resistance. We report a bedside dilemma in a child who experienced cardiopulmonary arrest from septic pulmonary embolism..

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Nutrition therapy in Paediatric patients requiring ExtraCorporeal Membrane Oxygenation: Protocol for a prospective observational multisite study (PAENUT ECMO)

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) provides life-sustaining gas exchange and haemodynamic support for critically ill patients with severe respiratory or circulatory failure. Paediatric patients supported on ECMO often represent..

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Extracorporeal membrane oxygenation for life-threatening measles in children: a case series

Abstract Measles is resurgent worldwide, and although vaccine-preventable, severe disease can progress to cardiorespiratory failure refractory to conventional support. This study aimed to determine whether extracorporeal membrane oxygenation (ECMO) is..

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Survival in Extracorporeal Cardiopulmonary Resuscitation for Pediatric In-Hospital Cardiac Arrest: Nationwide Cohort Study in Japan, 2011–2022

Abstract Objectives: To describe the rate, characteristics, and outcomes of pediatric extracorporeal cardiopulmonary resuscitation (ECPR) for in-hospital cardiac arrest (IHCA) in Japan and evaluate temporal trends. Design: Retrospective cohort using..

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How To Do It: Pediatric Extracorporeal Membrane Oxygenation (ECMO)

Abstract Extracorporeal membrane oxygenation (ECMO) is an invaluable tool in cardiac surgery. In pediatric patients, it is almost exclusively deployed by congenital cardiac surgeons who are sufficiently trained. Pediatric ECMO..

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The Unknown Others of Neonatal Respiratory Extracorporeal Membrane Oxygenation

Abstract Increasingly, more neonatal respiratory extracorporeal membrane oxygenation (ECMO) patients in the Extracorporeal Life Support Organization (ELSO) registry have a primary diagnosis of Other. These patients, in addition to those..

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Oxygenation Indices with Oxygen Challenge Test in Neonates During VA ECMO

Abstract Objective: To evaluate the response of various oxygenation indices to the oxygen challenge test (OCT), prior to decannulation, in neonates supported with VA ECMO for respiratory indications, and to..

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Open-access Cost-effectiveness of the timing of respiratory extracorporeal membrane oxygenation initiation in pediatric patients

Abstract Objective:  The aim of this study was to assess the cost-effectiveness of early versus late initiation of extracorporeal membrane oxygenation (ECMO) in pediatric patients with acute respiratory distress syndrome..

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Time to Pediatric Extracorporeal Membrane Oxygenation Circuit Failure: An Extracorporeal Life Support Organization Registry-Based Study

Abstract Circuit thrombosis and mechanical failure are important complications during extracorporeal membrane oxygenation (ECMO), but expected circuit duration and predictors of circuit failure remain poorly defined. We performed a retrospective..

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Pediatric Respiratory Failure and Support With Prolonged Extracorporeal Membrane Oxygenation: Multicenter Cohort Using the Extracorporeal Life Support Organization Registry, 1989–2021

Abstract Objectives: To characterize outcomes in children supported with 14 days or more of extracorporeal membrane oxygenation (ECMO) for respiratory indications. Design: Retrospective analysis of the Extracorporeal Life Support Organization..

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Impact of postcardiotomy ECMO utilization after the Norwood procedure in the United States

Abstract Background Norwood surgery is the first stage in the surgical palliation of hypoplastic left heart syndrome (HLHS) and its variants. Postcardiotomy extracorporeal membrane oxygenation (ECMO) may be required in..

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Extracorporeal membrane oxygenation in congenital cardiac surgery: a 10-year single-centre experience

Abstract Introduction:Extracorporeal Membrane Oxygenation (ECMO) has evolved as an effective mechanical support for cardiorespiratory failure in patients undergoing congenital cardiac surgery, and the threshold of using it has substantially reduced...

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Survival After Extracorporeal Membrane Oxygenation Decannulation Due to Poor Prognosis in Children—An Extracorporeal Life Support Organization Registry Study

Abstract Extracorporeal membrane oxygenation (ECMO) is a life-saving intervention for critically ill children. However, decisions regarding discontinuation due to poor prognosis remain ethically complex. While outcomes after successful weaning are..

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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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