American Society of Hirudotherapy

Extracorporeal membrane oxygenation (ECMO) in pediatric congenital heart disease: a comprehensive review

Review published in The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology (2025)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Narrative reviewGenomics & ProteomicsFaheem MSB et al. · The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2025

Abstract

BACKGROUND: Extracorporeal membrane oxygenation (ECMO), which provides life-saving assistance in severe cardiac and pulmonary failure cases, has emerged as an important technique in managing children with congenital heart disease (CHD). MAIN BODY: In this review, we discuss the evolution of ECMO over the years, its clinical uses, and the results in pediatric CHD. ECMO has been utilized as a bridge to recovery, in stabilizing an individual after surgery, and as a bridge to heart transplantation. Cannulation procedures that are adjusted according to the anatomy of an individual have improved outcomes, although bleeding and neurologic concerns remain a matter of concern. In addition, long-term neurodevelopmental disorders and renal failure are also among the alarming outcomes. The use of newer anticoagulant drugs like bivalirudin, which lowers the risk of bleeding, and genomic testing for personalized treatment are examples of recent developments. Furthermore, neuroprotective techniques such as erythropoietin and dexmedetomidine can also enhance the neurocognitive outcomes. Finally, improvements in monitoring systems and pump technology contribute to increased ECMO efficacy and safety. CONCLUSION: Despite these developments, ECMO's expense and restricted accessibility remain major obstacles, especially in areas with low resources. In this review, the advancements in ECMO technology and care are highlighted, and it also emphasizes future research to address the current challenges.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeJournal ArticleReview

Summary

Extracorporeal membrane oxygenation (ECMO), which provides life-saving assistance in severe cardiac and pulmonary failure cases, has emerged as an important technique in managing children with congenital heart disease (CHD).

Why This Matters for Hirudotherapy

This review discusses extracorporeal membrane oxygenation (ECMO) in pediatric congenital heart disease, covering its evolution, clinical uses (bridge to recovery, post-surgical stabilization, bridge to transplantation), complications such as bleeding and neurologic and renal concerns, and recent developments including newer anticoagulants like bivalirudin, noted for lowering bleeding risk, neuroprotective strategies, and monitoring and pump improvements. The abstract mentions bivalirudin only as one of several advances and contains no mention of hirudin, leeches, or leech-derived therapeutics. Consequently, no defensible connection to hirudotherapy or the leech secretome can be drawn from this abstract; relevance to ASH is not established.

Citation

Extracorporeal membrane oxygenation (ECMO) in pediatric congenital heart disease: a comprehensive review

Faheem MSB et al. · The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology, 2025

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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