Extracorporeal membrane oxygenation discontinuation despite technically successful reoperation: A case report

Death remains a probable outcome of pediatric cardiac extracorporeal membra ne oxygenation (ECMO) despite increasing efforts to improve the results. On veno-arterial ECMO, in an obviously hopeless situation, the decision to wi thdraw a life supporting measure resulting in the sudden death of a child p laces a heavy burden on the team. After valvulotomy of critical aortic sten osis in a prenatally diagnosed term neonate, ECMO had to be installed durin g postoperative resuscitation. Despite technically successful homograft imp lantation while on ECMO complicated by postoperative bleeding, advancing mu ltiorgan failure resulted in ECMO withdrawal. As shown in this case report, exact termination criteria are lacking but are necessary to prevent increa sing team and resource related conflicts in pediatric cardiac ECMO.