Editorial: Extra-corporeal membrane oxygenation in pediatric cardiac patients

[First paragraph] Bartlett pioneered the use of Extra-Corporeal Membrane Oxygenation (ECMO) for prolonged cardio-respiratory support in critical patients in the 1970's (1), reporting on the first pediatric patient to survive: a young child with myocardial dysfunction after surgery for transposition of the great arteries (2). Early clinical successes led to increased use of ECMO to support children with respiratory and cardiac failure. ECMO was initially used for resuscitation after cardiac arrest in pediatric patients, and then as peri-operative stabilization for palliative and corrective procedures for congenital heart defects. Despite the recent advances in Ventricular Assist Device technology, ECMO remains the most commonly used system of mechanical circulatory and respiratory assistance in pediatric cardiac patients. The advantages of ECMO include: its familiarity among the caregivers involved with the management of pediatric patients with complex congenital heart defects, the capability of providing cardiac (bi-ventricular) and respiratory support, the availability across all pediatric age and body weight groups and the relatively low costs. Furthermore, ECMO is ideal suited for pediatric patients with a combination of cardiac and respiratory failure, frequently occurring after repair of complex congenital heart defects, and in cases of rapid deployment during a cardio-circulatory arrest. Disadvantages of ECMO include the need of a dedicated team of specialists, intensive care monitoring and the risk of major potential complications such as bleeding, thrombosis, infections and multi-organ failure. In this Research Topic several experts in the field report on the state of the art knowledge on the topic.