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We explored short- and intermediate-term outcomes in these neonates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Body<\/jats:title>\n                    <jats:p>We systematically searched PubMed, EMBASE, Cochrane Central and Web of Science (final search: 25 February 2025). Comparative studies reporting outcomes for patients with versus without postoperative ECMO were included. Primary outcomes were short-term mortality, secondary outcomes included stages-2-and-3 palliation completion, operative times, recovery parameters, and complications. Statistical analysis used RevMan 5.4 to calculate pooled risk ratio (RR), odds ratios (OR) or mean differences (MD) with 95% confidence intervals employing random-effects models; heterogeneity was assessed using I\u00b2 statistics and Cochran\u2019s Q test.<\/jats:p>\n                    <jats:p>\n                      Eight studies (2,612 patients: 15% with ECMO) were included. In-hospital mortality was five times greater in the ECMO group (RR\u2009=\u20095.53, CI\u2009=\u20094.41\u20136.93,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0003), though survival to Glenn and Fontan completion were comparable. Cardiopulmonary bypass duration was significantly longer in the ECMO group (MD\u2009=\u200928.07\u00a0min, CI\u2009=\u200918.19\u201337.95,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0004). Postoperative ICU recovery was significantly prolonged for ECMO patients (MD\u2009=\u200910.56 days, CI\u2009=\u20091.28\u201319.83,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), though hospital recovery was similar. Postoperative atrioventricular valve regurgitation, Norwood reoperation, delayed chest closure, unplanned reoperation or death\/transplantation were comparable. Risk of bias (ROBINS-I) was formally assessed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our analysis supports that ECMO use post-Norwood procedure identifies a high-risk subgroup with significantly higher early-mortality and resource utilisation. However, this association must be interpreted cautiously due to heterogenous ECMO indications. Future efforts should focus on identifying modifiable risk factors to improve outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13019-026-04232-4","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T02:56:01Z","timestamp":1779504961000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Outcomes after extracorporeal membrane oxygenation following the norwood procedure: a systematic review and meta-analysis"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8407-1731","authenticated-orcid":false,"given":"Abdullah","family":"Almehandi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Altarkait","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahya","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Alhajri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed","family":"Alenezi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas","family":"Diniz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4667-9402","authenticated-orcid":false,"given":"Abdulrahman O.","family":"Al-Naseem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7805-9959","authenticated-orcid":false,"given":"Hamood","family":"Al Kindi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6205-2485","authenticated-orcid":false,"given":"Saif Awlad","family":"thani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"issue":"21","key":"4232_CR1","doi-asserted-by":"publisher","first-page":"2246","DOI":"10.1161\/CIRCULATIONAHA.117.029375","volume":"137","author":"JW Newburger","year":"2018","unstructured":"Newburger JW, Sleeper LA, Gaynor JW, Hollenbeck-Pringle D, Frommelt PC, Li JS, et al. 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