ECMO Considerations in the Pediatric Cardiac Population

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.