Pediatric surgical interventions on ECMO

R Scott Eldredge; Katie W Russell

doi:10.1016/j.sempedsurg.2023.151330

Pediatric surgical interventions on ECMO

Semin Pediatr Surg. 2023 Aug;32(4):151330. doi: 10.1016/j.sempedsurg.2023.151330. Epub 2023 Oct 17.

Authors

R Scott Eldredge¹, Katie W Russell²

Affiliations

¹ Department of Surgery, Mayo Clinic, Phoenix, AZ, United States; Department of Pediatric Surgery, Phoenix Children's, Phoenix, AZ, United States.
² Department of Surgery, Division of Pediatric Surgery, University of Utah, Salt Lake City, UT, United States. Electronic address: katie.russell@hsc.utah.edu.

PMID: 37931540
DOI: 10.1016/j.sempedsurg.2023.151330

Abstract

Extra Corporeal Membrane Oxygenation (ECMO) has historically been reserved for refractory pulmonary and cardiac support in children and adult. Operative intervention on ECMO was traditionally contraindicated due to hemorrhagic complications exacerbated by critical illness and anticoagulation needs. With advancements in ECMO circuitry and anticoagulation strategies operative procedures during ECMO have become feasible with minimal hemorrhagic risks. Here we review anticoagulation and operative intervention considerations in the pediatric population during ECMO cannulation. Pediatric surgical interventions currently described in the literature while on ECMO support include thoracotomy/thoracoscopy, tracheostomy, laparotomy, and injury related procedures i.e. wound debridement. A patient should not be precluded from a surgical intervention while on ECMO, if the surgery is indicated.

Keywords: ECLS; ECMO; Extra Corporeal Life Support; Extra Corporeal membrane Oxygenation; Operation; Pediatric; Procedure; Surgical Interventions.

Publication types

Review

MeSH terms

Anticoagulants
Child
Critical Illness
Extracorporeal Membrane Oxygenation* / methods
Humans
Specialties, Surgical*
Tracheostomy

Substances

Anticoagulants