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Impact of early hyperoxia on outcomes during neonatal and pediatric veno-arterial extracorporeal life support

Abstract Background: Hyperoxia induces oxidative stress and can exacerbate inflammatory response to Veno-Arterial Extracorporeal Life Support (VA–ECLS). This study aimed to evaluate the association between hyperoxia during VA–ECLS and morbidity, complications,..

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A bedside staffing model with perfusionists for pediatric extracorporeal membrane oxygenation (ECMO) at a high-volume center

Abstract Background: Extracorporeal membrane oxygenation (ECMO) in pediatric patients requires monitoring by specialists to optimize outcomes. Practice variability exists among pediatric ECMO centers across the country. We present a bedside..

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Bivalirudin Monitoring Using Dilute Thrombin Time in Pediatric Extracorporeal Membrane Oxygenation: Single-Center, Retrospective Cost Analysis, 2018–2023

Abstract Objectives:  The parenteral anticoagulant bivalirudin has favorable safety and efficacy outcomes compared with unfractionated heparin (UFH) in pediatric patients requiring extracorporeal membrane oxygenation (ECMO), and is frequently monitored using..

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Every second counts: Association between activated clotting time and neurologic injury in neonatal ECMO

Abstract Background Extracorporeal membrane oxygenation (ECMO) is a critical support modality for patients with reversible cardiopulmonary failure. Despite its benefits, ECMO is associated with neurologic adverse events (NAE), including seizures..

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Difficult cannulations in neonatal and pediatric ECMO: Illuminating obstructions to timely therapy

Abstract Introduction Extracorporeal membrane oxygenation (ECMO) provides life-saving support for patients with advanced cardiorespiratory failure, yet unanticipated difficulties with peripheral cannulation can delay therapy. This study describes challenging neonatal and..

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Sweep Gas Nitric Oxide During Extracorporeal Membrane Oxygenation in Neonates and Children (NECTAR Trial): A Single-Center, Pilot Randomized Controlled Trial

Abstract Objectives:  To test the feasibility and safety of a randomized controlled trial (RCT) delivering nitric oxide into the sweep gas of extracorporeal membrane oxygenation (ECMO) circuits (sNO) in critically..

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Pediatric ECPR as Bridge to Surgery: Successful Management of Refractory Cardiac Arrest in High-Risk ICD Lead Extraction

Abstract Background Refractory cardiac arrest remains a major challenge in children, with poor survival despite advances in cardiopulmonary resuscitation (CPR). Extracorporeal cardiopulmonary resuscitation (ECPR), defined as rapid deployment of extracorporeal..

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Pediatric Extracorporeal Membrane Oxygenation (ECMO) Transport Safety—Regional and National Experiences and Literature Review

Abstract Background/Objectives: Venovenous extracorporeal membrane oxygenation (VV ECMO) supports reversible respiratory failure when mechanical ventilation fails. Technological advances and specialized teams now enable ECMO initiation at referring centers, even for high-risk..

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Advances in Extracorporeal Life Support: A Pediatric Perspective

Abstract The last 10 years have seen an exponential rise in the use of extracorporeal life support (ECLS), also frequently referred to as ECMO (extracorporeal membrane oxygenation) when a membrane..

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Highlights of the Nineteenth International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion

Abstract The 19th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion took place on May 16 and 17, 2025, at the InRad Events Center of the..

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Follow-up of neonates who received ECMO: how are they doing?

Abstract Extracorporeal membrane oxygenation (ECMO) has been used since 1975 to provide temporary cardiorespiratory support in neonates, children, and adults with severe cardiopulmonary conditions unresponsive to conventional therapy. Initially focused..

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Correlation of anticoagulation assays with bleeding during extracorporeal membrane oxygenation at a tertiary pediatric hospital

Abstract Introduction Due to anticoagulation during Extracorporeal Membrane Oxygenation (ECMO), patients face a higher risk of bleeding. This study aimed to assess the correlation between anticoagulation assays and hemorrhage in..

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Unfractionated Heparin Dosing in Pediatric Venoarterial Extracorporeal Membrane Oxygenation: Single-Center Retrospective Study, 2015–2021

Abstract Objective:  Unfractionated heparin (UFH) is the most widely used anticoagulant during extracorporeal membrane oxygenation (ECMO). Optimal dosing of UFH for children undergoing ECMO is unknown, leading to suboptimal exposure...

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Flow benefits of pediatric arterial cannulae versus introducer sheaths as distal perfusion catheters in venoarterial extracorporeal membrane oxygenation

Abstract Objective We test the hypothesis that pediatric arterial (“peds art”) cannulae as distal perfusion catheters (DPCs) for venoarterial extracorporeal membrane oxygenation provide more favorable distal limb hemodynamics than introducer..

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Outcomes after postcardiotomy venoarterial extracorporeal membrane oxygenation in young patients: An individual patient data meta-analysis

Abstract Objective We aimed to evaluate the early and midterm mortality of young patients treated for cardiogenic shock with venoarterial extracorporeal membrane oxygenation (VA-ECMO) after adult cardiac surgery. Methods Studies..

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Platelet Transfusion Thresholds for Children Supported by Extracorporeal Membrane Oxygenation: The Extracorporeal Membrane Oxygenation Hemostatic Transfusions in Children (ECSTATIC) Feasibility…

Abstract Objectives:  To evaluate the feasibility of randomizing children on extracorporeal membrane oxygenation (ECMO) to one of two prophylactic platelet transfusion thresholds. Design:  Randomized controlled trial. Setting:  Ten ECMO centers..

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The comparison of circuit lifespan between integration and separation approach in extracorporeal membrane oxygenation patients requiring continuous renal replacement therapy…

Abstract Background: The estimated incidence of acute kidney injury requiring renal replacement therapy (RRT), mainly continuous RRT (CRRT), in patients necessitating extracorporeal membrane oxygenation (ECMO) is approximately 50%. Currently, two..

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Death by Neurologic Criteria in Neonates Undergoing Extracorporeal Membrane Oxygenation: Extracorporeal Life Support Organization Registry Study, 2010–2023

Abstract Objectives:  To identify factors associated with the development of death by neurologic criteria (DNC) in neonates treated with extracorporeal membrane oxygenation (ECMO). Design:  Retrospective registry study. Setting:  Data reported..

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Preoperative Extracorporeal Membrane Oxygenation in Children With Dextro-Transposition of the Great Arteries: Extracorporeal Life Support Organization Registry Study, 2000–2022

Abstract Objective:  To describe those neonates with dextro-transposition of the great arteries (d-TGA) who undergo preoperative support with extracorporeal membrane oxygenation (ECMO) and to compare outcomes in those undergoing the..

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Pediatric venoarterial and venovenous ECMO

Abstract  (ECMO) is an invaluable resource in the treatment of critically ill children with cardiopulmonary failure.  To date, over 36,000 children have been placed on ECMO and the utilization of..

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A consensus of international experts on definition, sampling, treatment, and prevention of peripheral extracorporeal membrane oxygenation cannula-site infection obtained by…

Abstract Background: Nosocomial infections are common in patients receiving extracorporeal membrane oxygenation (ECMO), with ECMO cannula‑site infections (ECMO‑CSI) being the most frequent infections directly related to the ECMO run. These..

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Outcomes of Modified Extracorporeal Membrane Oxygenation Using A Cardiopulmonary Bypass Circuit in Postcardiotomy Children With Congenital Heart Disease—A Ten-Year Experience…

Abstract Objectives: Extracorporeal membrane oxygenation (ECMO) plays a crucial role in the outcome of children following surgery for congenital heart disease. However, its availability and affordability are minimal across the globe...

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Staged mechanical circulatory support in paediatric HIT: Bivalirudin anticoagulation across ECMO, VAD, and cardiac transplantation

Abstract Introduction Heparin induced thrombocytopenia (HIT) with in paediatric population is rare and subsequent anticoagulation management is challenging. Bivalirudin is a viable alternative to heparin for anticoagulating paediatric patients with..

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Peripheral veno-arterial ECMO cannulation in children: Review of the relevant ELSO publications

Abstract Background Peripheral veno-arterial (VA) extracorporeal membrane oxygenation (ECMO) cannulation in children poses a significant clinical challenge due to wide variations in body size, vessel caliber, and risk profiles. Purpose..

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Stabilizing the Unstable: An Analysis of The Society of Thoracic Surgeons Congenital Heart Surgery Database of Children Supported With Extracorporeal…

Abstract Background Children with heart disease and cardiopulmonary failure may be supported with extracorporeal membrane oxygenation (ECMO) for stabilization before cardiac surgery. This study describes their epidemiology and outcomes. Methods..

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A Comparative Analysis of Bivalirudin and Heparin for Extracorporeal Membrane Oxygenation in a Pediatric Cardiothoracic Intensive Care Unit

Abstract Unfractionated heparin has long been the conventional anticoagulant for pediatric mechanical circulatory support (MCS). As bivalirudin has gained traction in ventricular assist devices (VAD) management, its role in extracorporeal..

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Extracorporeal Membrane Oxygenation Initiated in the Operating Room After Congenital Heart Surgery : A Single-Center Review of Survival Outcomes

Abstract Objectives To describe the incidence and survival of extracorporeal membrane oxygenation (ECMO) deployment in the operating room (OR) for failure to wean from cardiopulmonary bypass (CPB) after surgery for..

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Follow-Up Brain MRI After Carotid Reconstruction or Ligation in Neonatal Venoarterial Extracorporeal Membrane Oxygenation: Single-Center Retrospective Cohort, 2009–2022

Abstract Objectives:  In neonates, the carotid artery can be ligated or reconstructed at the time of decannulation from venoarterial extracorporeal membrane oxygenation (VA-ECMO). However, there is a paucity of data..

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Antithrombin Supplementation in Extracorporeal Membrane Oxygenation: A Systematic Review With Meta-Analysis

Abstract Background The Extracorporeal Life Support Organization recommends daily antithrombin monitoring and supplementation to achieve > 50%–80% activity during extracorporeal membrane oxygenation (ECMO). Evidence supporting this practice is uncertain, and whether..

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Functional Status Change in Pediatric Extracorporeal Membrane Oxygenation Survivors is Equivalent to Propensity-Matched Patients Managed Without Extracorporeal Membrane Oxygenation

Abstract Extracorporeal membrane oxygenation (ECMO) is now commonly used to manage refractory pediatric cardiac or respiratory failure. Traditionally, ECMO has been associated with high morbidity. However, despite advancements in ECMO..

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