Extracorporeal Membrane Oxygenation in Congenital Heart Disease

Area of Science:

• Pediatric Cardiology
• Cardiopulmonary Support
• Biomedical Engineering

Background:

• Mechanical circulatory support (MCS) is critical for severe pediatric cardiac or respiratory failure.
• Extracorporeal membrane oxygenation (ECMO) and ventricular assist devices (VADs) are primary MCS modalities in children.
• ECMO and VADs have distinct yet overlapping roles in managing pediatric cardiopulmonary compromise.

Purpose of the Study:

• To review the historical development and application of ECMO in pediatric patients.
• To highlight the impact of the Extracorporeal Life Support Organization (ELSO) on ECMO guidelines and outcomes.
• To discuss the current utilization, morbidity, and mortality associated with ECMO in children with congenital heart disease.

Main Methods:

• Historical review of ECMO development and application.
• Analysis of data from the Extracorporeal Life Support Organization (ELSO).
• Examination of advancements in ECMO technology and utilization trends.

Main Results:

• ECMO's use in pediatrics originated in the 1950s and saw its first pediatric congenital heart disease application in 1970.
• The formation of ELSO in 1989 standardized ECMO use and improved data collection.
• Technological and guideline advancements have led to significant improvements in ECMO utilization, morbidity, and mortality.

Conclusions:

• ECMO has evolved into a crucial therapy for pediatric patients with severe cardiopulmonary compromise.
• Standardized guidelines and technological improvements have enhanced ECMO's effectiveness and safety.
• This review focuses on ECMO's specific role in managing children with congenital heart disease.