Extracorporeal membrane oxygenation as a resuscitative measure in the pediatric emergency department.

BACKGROUND Extracorporeal membrane oxygenation (ECMO) may serve as a bridge to regain cardiac function in refractory resuscitation. However, its use has so far been limited owing to low availability, especially in emergency departments. OBJECTIVES To describe two children with acute myocarditis successfully treated with ECMO in the emergency department of a tertiary pediatric medical center. DESCRIPTION The children presented with vomiting, followed by rapid deterioration to cardiogenic shock that failed to respond to conservative treatment. Given the urgency of their condition and its presumably reversible (viral) etiology, treatment with ECMO was initiated in the department's resuscitation room. RESULTS Outcome was excellent, and cardiac function remained normal throughout 6 and 10 months follow-up. CONCLUSIONS Extracorporeal life support has enormous potential in the emergency department and warrants further assessment.