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Rupture of the common carotid artery after extracorporeal membrane oxygenation
Galia Grisaru-Soen1, John G Coles, Brian P Kavanagh
1Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.
Abstract:
The use of extracorporeal membrane oxygenation may be life saving but may result in serious complications. We report a rupture of the carotid artery secondary to fungal infection of the cannulation site in a pediatric patient requiring extracorporeal membrane oxygenation while awaiting a heart transplant. Prompt diagnosis and surgery resulted in a favorable outcome.
Insights
Extracorporeal membrane oxygenation (ECMO) can cause serious complications like fungal infections. This case study details a pediatric patient who experienced carotid artery rupture due to a fungal infection at the ECMO cannulation site, successfully treated with surgery.
Area of Science:
- Cardiology
- Infectious Diseases
- Pediatric Surgery
Background:
- Extracorporeal membrane oxygenation (ECMO) is a critical life support technology for critically ill patients.
- Serious complications, including infections at the cannulation site, can arise during ECMO therapy.
- Pediatric patients awaiting heart transplantation are particularly vulnerable to ECMO-related complications.
Observation:
- A pediatric patient on ECMO for heart transplantation developed a fungal infection at the cannulation site.
- The fungal infection led to a severe complication: rupture of the carotid artery.
- This complication posed a significant threat to the patient's life.
Findings:
- Prompt diagnosis of the fungal infection and subsequent carotid artery rupture was crucial.
- Surgical intervention was required to address the arterial rupture.
- The patient experienced a favorable outcome following timely medical and surgical management.
Implications:
- Highlights the risk of invasive fungal infections in ECMO patients.
- Underscores the importance of vigilant monitoring for cannulation site complications.
- Emphasizes the need for rapid diagnosis and surgical intervention in managing vascular emergencies during ECMO.
- Suggests potential for improved antifungal protocols or site care in pediatric ECMO patients.