ArticlePediatric cardiology2026
Utility of Echocardiography in 173 VA ECMO Clamp Trials in Babies and Children.
Article in Pediatric cardiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
7 authors.
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Abstract
Venoarterial extracorporeal membrane oxygenation (VA ECMO) offers vital support to children with cardiopulmonary failure. Echocardiography is commonly used to assess readiness for decannulation, however pediatric data supporting utility is limited. This is a retrospective, single-center study analyzing echoes during pediatric VA ECMO clamp trials from 2012 ̶ 2024. Subjects were categorized as cardiomyopathy/myocarditis (CM), persistent pulmonary hypertension of the newborn (PPHN), or congenital heart disease (CHD). Subjects were grouped as those who did (+ decan) and did not (− decan) tolerate decannulation within 24 h of the trial. 103 subjects (median age 9.1 days (3.7–109.5 days), 39% female), underwent 173 unique clamp trial echoes. 49.1% (n = 85) of patients were decannulated within 24 h of first clamp trial. In the PPHN group each 1 m/s increase in tricuspid regurgitation peak velocity was associated with 73% lower odds of +decan (OR = 0.27, CI: 0.09–0.79, p = 0.02), and > mild atrioventricular valve regurgitation was associated with 84% lower odds of having + decan (OR = 0.16, CI: 0.04–0.69, p = 0.01). In the CM group, each 5% decrease in left ventricular ejection fraction was associated with 29% lower odds of having + decan (OR = 0.71, CI: 0.53–0.95, p = 0.02). No echo associations with decannulation outcome were found in the CHD group. Predictors of a well-tolerated ECMO decannulation include lower tricuspid regurgitation peak velocity and < mild atrioventricular valve regurgitation in PPHN and higher left ventricular ejection fraction in CM. Because CHD was split into single and two ventricle groups, the resulting small sample size limited evaluation for CHD patients, which deserves further study.
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Registered trials
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