Advancing Pediatric eCPR: Challenges and Urgency for Evidence Generation

In this World Shared Practice Forum podcast, Dr. Dennis Daniel discusses pediatric extracorporeal life support (ECLS) with experts Drs. Peta Alexander and Ryan Barbaro. They explore the differences between pediatric and adult extracorporeal cardiopulmonary resuscitation (ECPR), highlighting differing causes of cardiac arrest and the interpretation of recently published studies. The discussion also covers supply chain issues affecting ECMO availability, the importance of standardized, evidence-based practices to identifying ECMO-associated complications, and opportunities for future research into ECMO use and outcomes. LEARNING OBJECTIVES - Identify the key differences between pediatric and adult extracorporeal cardiopulmonary resuscitation (ECPR), focusing on technical challenges and typical causes of cardiac arrest - Discuss the challenges facing standardization of pediatric ECMO care, including supply chain issues and approaches to capturing and classifying ECMO-associated complications - Describe areas of need and opportunity for future research in pediatric ECMO AUTHORS Peta Alexander, MBBS, FRACP, FCICM Senior Associate Cardiologist Director of ECMO Program Boston Children’s Hospital Associate Professor in Pediatrics Harvard Medical School Ryan Barbaro, MD, MSc Service Chief of Pediatric Critical Care Medicine Director of Pediatric ECMO C.S. Mott Children's Hospital Clinical Associate Professor in Pediatric Critical Care University of Michigan Dennis Daniel, MD ECMO Medical Director, Medical-Surgical ICU Associate Director, OPENPediatrics Boston Children’s Hospital DATE Initial publication date: January 27, 2025. ARTICLES REFERENCED AND ADDITIONAL RESOURCES - Alexander PMA, Di Nardo M, Combes A, et al. Definitions of adverse events associated with extracorporeal membrane oxygenation in children: results of n international Delphi process from the ECMO-CENTRAL ARC. Lancet Child Adolesc Health. 2024;8(10):773-780. https://pubmed.ncbi.nlm.nih.gov/39299748/ - UK collaborative randomised trial of neonatal extracorporeal membrane oxygenation. UK Collaborative ECMO Trail Group. Lancet. 1996;348(9020):75-82. https://pubmed.ncbi.nlm.nih.gov/8676720/ - Biomarkers of Brain Injury in Critically-Ill Children on Extracorporeal Membrane Oxygenation (ECMOhttps://reporter.nih.gov/project-details/10545733 - TITRE - Trial of Indication-based Transfusion of Red Blood Cells in ECMO, https://www.childrenshospital.org/clinical-trials/nct05405426 - ASCEND study: https://chear.org/our-research/projects/ascend-ards-children-and-ecmo-initiation-strategies-impact-neuro-development TRANSCRIPT https://cdn.bfldr.com/D6LGWP8S/at/bzpc2445cxrk9zch4wqvjjs5/012525_WSP_Updates_in_Pediatric_ECMO.pdf Please visit: http://www.openpediatrics.org OPENPediatrics™ is an interactive digital learning platform for healthcare clinicians sponsored by Boston Children’s Hospital and in collaboration with the World Federation of Pediatric Intensive and Critical Care Societies. It is designed to promote the exchange of knowledge between healthcare providers around the world caring for critically ill children in all resource settings. The content includes internationally recognized experts teaching the full range of topics on the care of critically ill children. All content is peer-reviewed and open access, thus at no expense to the user. For further information on how to enroll, please email: openpediatrics@childrens.harvard.edu CITATION Alexander PMA, Barbaro RP, Daniel D. Updates in Pediatric ECMO: Challenges and Opportunities. 01/2025. OPENPediatrics. Online Podcast. https://soundcloud.com/openpediatrics/updates-in-pediatric-ecmo-challenges-and-opportunities-by-p-alexander-r-barbaro-openpediatrics.