WOFAPS 2025 8th World Congress of Pediatric Surgery

Santiago Correa, Edgar Salamanca, Jhon Escobar, Luz Garzon

Fundacion Cardioinfantil

Extracorporeal life support therapy is an additional tool for managing critically ill patients; however, it is generally not a therapy that contributes to the etiological management of the patient's critical condition per se, but rather a bridge therapy while specific medical intervention or management is performed. Despite the high risk of bleeding, some surgical interventions may be required in pediatric patients on ECMO. We present a series of cases of patients who underwent interventions from 2023 to April 2025, totaling 10 patients.

There were 4 cases of congenital diaphragmatic hernia, with tolerance to weaning from therapy; however, 3 had mortality after decannulation associated with pulmonary hypertension. Three patients underwent airway interventions, one for a foreign body , one for congenital tracheal stenosis, one for recurrent tracheoesophageal fistula, all of them surviving . Two patients had interventions for persistent bronchopleural fistulas, with intraoperative bleeding requiring multiple transfusions, but both patients survived and achieved disease control. Lastly, one patient with abdominal sepsis secondary to ascariasis achieved etiological control and survival.

Patients on ECMO support for whom surgical intervention leads to the control of the etiology of the critical condition should be evaluated by a multidisciplinary team, and the intervention should be performed at the optimal time to control the cause and allow weaning from extracorporeal life support.