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Extracorporeal membrane oxygenation in the pediatric population - who should go on, and who should not

Eric W Etchill1, Siddhartha A Dante2, Alejandro V Garcia1

  • 1Johns Hopkins University, Division of Pediatric General Surgery.

Current Opinion in Pediatrics
|April 26, 2020
PubMed

Insights

Extracorporeal membrane oxygenation (ECMO) is expanding for neonates and children. This review covers current evidence on ECMO indications, strategies, outcomes, and special populations, guiding clinicians on its evolving use.

Area of Science:

  • Pediatric critical care medicine
  • Cardiopulmonary support technologies
  • Neonatal and pediatric cardiology

Background:

  • Extracorporeal membrane oxygenation (ECMO) provides vital cardiorespiratory support.
  • Its application in neonates and children is continuously expanding.
  • Understanding current evidence is crucial for effective patient management.

Purpose of the Study:

  • To review the current landscape of ECMO in neonates and children.
  • To present the most recent evidence on ECMO indications and applications.
  • To highlight evolving aspects and unanswered questions in pediatric ECMO.

Main Methods:

  • Comprehensive review of recent literature on pediatric ECMO.
  • Analysis of evidence for different ECMO modalities (VV, VA, ECPR).
  • Discussion of patient selection, anticoagulation, and monitoring.

Main Results:

  • Evidence-based guidance on indications and contraindications for various ECMO types.
  • Review of anticoagulation strategies and end-organ function monitoring.
  • Outcomes data focusing on survival and neurologic status in different pediatric populations.

Conclusions:

  • Neonatologists and pediatricians must stay updated on ECMO evidence.
  • Awareness of ECMO indications, applications, and limitations is essential.
  • Ongoing research is needed to address evolving questions in pediatric ECMO.
Abstract

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