43: Modified ECMO in pediatric and neonatal patients. A cost effective solution for post-cardiotomy shock management.

Introduction: Post-cardiotomy shock is a major cause of morbidity and mortality in pediatric and neonatal patients after cardiac surgery. This study investigates the use of modified cardiopulmonary bypass (CPB) circuits as a cost-effective alternative to conventional ECMO systems for short-term support in managing post-cardiotomy shock. The aim of our research was to evaluate the cost-effectiveness of converting conventional CPB circuits into closed ECMO systems for managing post-cardiotomy shock in pediatric and neonatal patients, while maintaining optimal clinical outcomes. Methods: We assessed the adaptation of CPB circuits into closed ECMO setups, using CPB oxygenators for temporary support. Cost savings, duration of ECMO support, complication rates, and patient outcomes where analyzed. Results: The modified CPB-ECMO strategy resulted in significantly lower costs without compromising clinical outcomes. Early ECMO initiation reduced support duration and complications, further contributing to cost savings. Conclusions: The conversion of CPB circuits into ECMO systems offers a cost-effective and efficient solution for managing post-cardiotomy shock in pediatric and neonatal patients, making ECMO more accessible in resource-limited settings.