Pediatric ECMO Research: The Case for Collaboration

Area of Science:

• Pediatric Critical Care Medicine
• Cardiopulmonary Support
• Medical Technology Research

Background:

• Pediatric extracorporeal membrane oxygenation (ECMO) use has significantly increased over the past decade.
• Indications and case complexity for pediatric ECMO have expanded beyond the neonatal period.
• Despite increased use, no randomized controlled trials exist for non-neonatal pediatric ECMO interventions.

Purpose of the Study:

• To review the history of clinical research in pediatric ECMO.
• To discuss the methodological challenges in conducting pediatric ECMO research.
• To explore opportunities for future collaborative research in pediatric ECMO.

Main Methods:

• Literature review of historical clinical research in pediatric ECMO.
• Discussion of challenges including patient heterogeneity, technological advancements, and inter-institutional variability.
• Exploration of existing infrastructure for multicenter research collaborations.

Main Results:

• Significant growth in pediatric ECMO utilization and complexity noted.
• Key methodological hurdles identified: age/diagnosis heterogeneity, rapid technological evolution, enrollment feasibility, and management variability.
• Opportunities for future research through existing multicenter, multi-network infrastructure highlighted.

Conclusions:

• Conducting randomized controlled trials in pediatric ECMO is complex but crucial for evidence-based practice.
• Addressing methodological challenges is essential for advancing the field.
• Collaborative research efforts are vital for improving outcomes for critically ill children requiring ECMO.