ECMO in the management of cardiac failure

Extracorporeal membrane oxygenation (ECMO) can provide univentricular or biventricular cardiac, as well as respiratory, support; it has extended the application of ECMO to infants and children who develop refractory cardiogenic shock before or after repair of congenital heart defects. The Pediatric Cardiac ECMO Registry, recently established by the Extracorporeal Life Support Organization, reports an overall survival rate of 47%. All were believed to have little chance of survival without mechanical support. ECMO has also been used for perioperative cardiac support after cardiac transplant. Hemorrhage remains the most common complication of ECMO. The future of ECMO for cardiac support depends on development of methods to prevent cardiac failure, improved ECMO techniques, and increased pediatric cardiac transplantation.