Extra Corporeal Membrane Oxygenation (ECMO) has historically been reserved for refractory pulmonary and cardiac support in children and adult. Operative intervention on ECMO was traditionally contraindicated due to hemorrhagic complications exacerbated by critical illness and anticoagulation needs. With advancements in ECMO circuitry and anticoagulation strategies operative procedures during ECMO have become feasible with minimal hemorrhagic risks. Here we review anticoagulation and operative intervention considerations in the pediatric population during ECMO cannulation. Pediatric surgical interventions currently described in the literature while on ECMO support include thoracotomy/thoracoscopy, tracheostomy, laparotomy, and injury related procedures i.e. wound debridement. A patient should not be precluded from a surgical intervention while on ECMO, if the surgery is indicated.

体外膜肺氧合 (ECMO) 历来被保留用于儿童和成人难治性肺和心脏支持。传统上，ECMO 的手术干预是禁忌的，因为危重疾病和抗凝需求会加剧出血并发症。随着 ECMO 电路和抗凝策略的进步，ECMO 期间的手术程序已变得可行，出血风险最小。在这里，我们回顾一下 ECMO 插管期间儿科人群的抗凝和手术干预注意事项。目前文献中描述的在 ECMO 支持下的儿科手术干预措施包括开胸术/胸腔镜检查、气管切开术、剖腹手术和损伤相关手术，即伤口清创术。如果需要手术，不应阻止患者在 ECMO 期间接受手术干预。