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Pediatric surgical interventions on ECMO.

R Scott Eldredge1, Katie W Russell2

  • 1Department of Surgery, Mayo Clinic, Phoenix, AZ, United States; Department of Pediatric Surgery, Phoenix Children's, Phoenix, AZ, United States.

Seminars in Pediatric Surgery
|November 6, 2023
PubMed
Summary
This summary is machine-generated.

Pediatric surgical interventions on Extra Corporeal Membrane Oxygenation (ECMO) are now feasible due to improved anticoagulation and circuitry. Indications for surgery should not be limited by ECMO support in pediatric patients.

Keywords:
ECLSECMOExtra Corporeal Life SupportExtra Corporeal membrane OxygenationOperationPediatricProcedureSurgical Interventions

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Area of Science:

  • Pediatric Surgery
  • Cardiopulmonary Support
  • Critical Care Medicine

Background:

  • Extra Corporeal Membrane Oxygenation (ECMO) traditionally limited operative interventions due to bleeding risks.
  • Advancements in ECMO technology and anticoagulation have reduced hemorrhagic complications.
  • Pediatric patients on ECMO require careful consideration for surgical procedures.

Approach:

  • Review of current literature on pediatric surgical interventions during ECMO.
  • Analysis of anticoagulation strategies and their impact on surgical safety.
  • Discussion of specific procedures performed on pediatric ECMO patients.

Key Points:

  • Pediatric surgical interventions on ECMO include thoracotomy, tracheostomy, laparotomy, and wound debridement.
  • Improved ECMO circuitry and anticoagulation minimize bleeding risks during surgery.
  • Surgical intervention should be based on patient indication, not solely on ECMO status.

Conclusions:

  • Pediatric surgical interventions are increasingly feasible and safe during ECMO support.
  • ECMO should not preclude indicated surgical procedures in pediatric patients.
  • Careful management of anticoagulation is crucial for successful operative outcomes on ECMO.