• Katherine L Zaleski, Rebecca L Scholl, Ravi R Thiagarajan, Diego Porras, Douglas Mah, James A DiNardo, and Viviane G Nasr.
• Department of Anesthesiology, Critical Care Medicine and Pain Medicine, Division of Cardiac Anesthesia, Boston Children's Hospital, Boston, MA. Electronic address: katherine.zaleski@childrens.harvard.edu.
• J. Cardiothorac. Vasc. Anesth. 2019 Jul 1; 33 (7): 1932-1938.

ObjectiveThe utility of extracorporeal membrane oxygenation (ECMO) as an elective support modality for high-risk cardiac procedures is extensively described in adults, but its use in children is limited to isolated reports. The objective of this study was to analyze the outcomes of patients who underwent elective cannulation to ECMO for this purpose.DesignSingle-center, retrospective chart review.SettingFree-standing pediatric tertiary care center.ParticipantsPatients who underwent elective cannulation to ECMO for cardiorespiratory support during a high-risk cardiac catheterization procedure.InterventionsElective ECMO cannulation for high-risk percutaneous cardiac interventions or electrophysiology procedures.Measurements And Main ResultsSurvival to discharge was 71.4% compared with 30% for patients who required extracorporeal cardiopulmonary resuscitation in the cardiac catheterization laboratory. The mean duration of cannulation was 137.43 hours (range 27-615 h, median 55 h). There were no major neurologic sequelae, but ECMO circuit thrombosis (57%) was relatively common.ConclusionThe use of elective ECMO support for high-risk pediatric cardiac catheterizations can be accomplished safely and may allow for an improved rate of survival with lower rates of severe adverse events compared with extracorporeal cardiopulmonary resuscitation as rescue therapy.Copyright © 2019 Elsevier Inc. All rights reserved.

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