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Published on: January 17, 2025
Pediatric and neonatal extracorporeal life support: current state and continuing evolution
Brian P Fallon1, Samir K Gadepalli2, Ronald B Hirschl2
1Department of Surgery, ECLS Laboratory, B560 MSRB II/SPC 5686, Michigan Medicine, University of Michigan, 1150 W. Medical Center Drive, Ann Arbor, MI, 48109, USA. bfallon@med.umich.edu.
Extracorporeal life support (ECLS) is increasingly used in pediatric and neonatal patients. Technological advancements have expanded ECLS applications, indications, and management strategies for improved patient outcomes.
Area of Science:
- Pediatric critical care medicine
- Cardiopulmonary support technologies
- Neonatal intensive care
Background:
- Extracorporeal life support (ECLS) use in pediatric and neonatal populations is rising.
- Significant advancements in ECLS technology and safety have broadened its applicability.
- The evolving landscape necessitates updated clinical understanding and practice.
Purpose of the Study:
- To review the current state of pediatric and neonatal ECLS.
- To discuss advancements in ECLS technology, indications, and management.
- To provide an overview of modern ECLS patient care.
Main Methods:
- Review of current literature and technological advancements in ECLS.
- Analysis of expanding indications and decreasing contraindications for ECLS.
- Description of traditional and hybrid cannulation techniques.
- Examination of updated circuit components and management protocols.
Main Results:
- ECLS technology and safety have improved, expanding its use.
- Indications for ECLS are broadening, while contraindications are narrowing.
- Innovations include hybrid cannulation, improved circuit components, and advanced patient management.
Conclusions:
- Modern ECLS offers expanded therapeutic options for critically ill pediatric and neonatal patients.
- Continuous technological innovation and refined management protocols are key to optimizing ECLS outcomes.
- A comprehensive approach to ECLS, encompassing technical and clinical aspects, is essential.
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