Technique or Application

ECMO to CPB: A single circuit approach

Nemours Children’s Hospital, 1600 Rockland Road, Wilmington, DE, 19803, USA

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Received: 30 December 2024
Accepted: 11 July 2025

Abstract

Background: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) and cardiopulmonary bypass (CPB) are used during pediatric heart surgery to provide cardiopulmonary support to patients as they undergo and recover from surgical procedures. On occasion, CPB and extracorporeal membrane oxygenation (ECMO) circuits are used within the same surgical period. In this technique article, we report on our experience using an ECMO circuit with the addition of a cardiotomy reservoir to convert to CPB. Methods: Patients on VA-ECMO were converted to CPB by the splicing of a cardiotomy reservoir and ECMO circuit. Results: Seven patients underwent conversion from VA-ECMO to CPB with a total of eight procedures. Mean nadir hematocrit on CPB was 31.1% ± 6.06. Mean blood product usage on CPB was 238 ± 155 mL. All the patients were decannulated from CPB or ECMO. Conclusion: Conversion from VA-ECMO to CPB with the use of the same circuit is an effective technique for congenital heart patients on VA-ECMO who require surgical intervention with CPB.