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Extracorporeal Membrane Oxygenation for Cardiac Indications in Children

Thiagarajan, Ravi R. MBBS, MPH

doi: 10.1097/PCC.0000000000000753
Organ Systems: Cardiopathophysiology and Disorders

Objectives: The objectives of this review are to discuss the use of extracorporeal membrane oxygenation following surgery for congenital heart disease, myocarditis and as a bridge to cardiac transplantation. In addition, the latest in circuit equipment, the management of anticoagulation and blood transfusions, and short- and long-term outcomes are reviewed.

Data Source: MEDLINE, PubMed.

Conclusions: The use of extracorporeal membrane oxygenation to support children with heart disease is increasing. There is wide variability in the use and management of extracorporeal membrane oxygenation between centers. Many areas of extracorporeal membrane oxygenation management warrant additional research to inform clinical practice and improve patient outcomes, including the use of extracorporeal membrane oxygenation in patients undergoing single ventricle palliation, optimizing strategies for monitoring and titrating anticoagulation therapies, and efforts directed at minimizing the risk of neurologic injury.

Department of Pediatrics, Section of Cardiology, Harvard Medical School, Boston Children’s Hospital, Boston, MA.

Dr. Thiagarajan’s institution consulted for Bristol Myers Squibb (Events Adjudication Committee) and received funding from Bristol Myers Squibb (Co-Chair of Extracorporeal Membrane Oxygenation Registry of the Extracorporeal Life Support Organization).

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©2016The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies