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Updated: Aug 5, 2026

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting
03:40

Point-of-Care Ultrasound for Peripheral Veno-Arterial Extracorporeal Membrane Oxygenation Without Left Ventricular Venting

Published on: January 17, 2025

Considerations and future challenges in managing ECMO for pediatric patients

Koichi Kashiwa1, Kent Doi2, Fumiaki Shikata3

  • 1Department of Clinical Engineering, The University of Tokyo Hospital, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, Japan. kashiwak-sup@h.u-tokyo.ac.jp.

Journal of Artificial Organs : the Official Journal of the Japanese Society for Artificial Organs
|July 30, 2026
PubMed

Insights

Pediatric extracorporeal membrane oxygenation (ECMO) using adult centrifugal pumps increases risks of thrombus and hemolysis. Development of pediatric-specific ECMO systems, including low-flow centrifugal pumps, is needed to improve patient outcomes.

Area of Science:

  • Biomedical Engineering
  • Pediatric Critical Care
  • Cardiovascular Research

Background:

  • Extracorporeal membrane oxygenation (ECMO) management requires preventing thrombus formation and hemolysis.
  • Centrifugal pumps are increasingly used in pediatric ECMO, but low-flow specific pumps are not approved in Japan, leading to the use of adult pumps.

Purpose of the Study:

  • To highlight the increased risks of thrombus formation and hemolysis in pediatric ECMO when using adult centrifugal pumps.
  • To emphasize the need for specialized pediatric ECMO systems, including low-flow centrifugal pumps.

Main Methods:

  • Review of current practices and challenges in pediatric ECMO management.
  • Analysis of risks associated with using adult centrifugal pumps in pediatric patients.

Main Results:

  • Using adult centrifugal pumps in pediatric ECMO enlarges flow paths, increasing thrombus formation risk.
  • Low-flow rates with adult centrifugal pumps significantly increase shear stress, leading to higher hemolysis incidence in pediatric cases.

Conclusions:

  • Current practices in Japan necessitate using adult centrifugal pumps for pediatric ECMO, elevating complication risks.
  • Development and approval of pediatric-specific ECMO systems, particularly low-flow centrifugal pumps, are crucial for reducing complications and improving outcomes.

Keywords:
Centrifugal pumpHemolysisThrombus formation

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