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ECMO Considerations in the Pediatric Cardiac Population

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Abstract

Purpose of Review

We discuss indications, contraindications, and outcomes, while addressing unique considerations for the use of extracorporeal membrane oxygenation (ECMO) in pediatric patients with cardiac disease.

Recent Findings

Increasing clinical experience and research in ECMO utilization for pediatric patients with cardiac disease have led to better understanding of the role of timing of postoperative cannulation, strategies for single ventricle anatomy, left heart decompression, management of anticoagulation, the role of venovenous ECMO, and long-term outcomes and follow-up in this patient population.

Summary

The use of ECMO for congenital and acquired heart disease has increased over time, with improving survival to hospital discharge. As more patients are cannulated onto ECMO, focus must shift towards optimizing management to further improve morbidity and mortality. Increased survival to discharge also requires that patients have structured follow-up to help maximize long term neurodevelopmental outcomes and quality of life post-critical illness with ECMO support.

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Funding

M.M.B’s institution received funding from the National Institute of Neurological Disorders and Stroke (R01NS106292).

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University School of Medicine, 1800 Orleans Street, Bloomberg Suite 6321, Baltimore, MD, 21287, USA

    Anisha S. Nadkarni, Dennis R. Delany, Jennifer Schramm & Melania M. Bembea

  2. Division of Cardiovascular Surgery, Congenital Heart Disease Center, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea

    Yu Rim Shin

  3. Heart and Lung Division, Great Ormond Street Hospital National Institute Health Research Biomedical Research Centre, London, UK

    Aparna Hoskote

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  1. Anisha S. Nadkarni
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Nadkarni, A.S., Delany, D.R., Schramm, J. et al. ECMO Considerations in the Pediatric Cardiac Population. Curr Pediatr Rep 11, 86–95 (2023). https://doi.org/10.1007/s40124-023-00292-5

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