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Published on: August 15, 2022
Successful use of extracorporeal membrane oxygenation in a child with obstructive shock due to massive bilateral
Aditya Badheka1, Pradeep Bangalore Prakash1, Veerajalandhar Allareddy1
1Division of Pediatric Critical Care, Stead Family Children's Hospital, University of Iowa, Iowa City, IA, USA.
Background:
Acute massive pulmonary embolism (PE) is a very rare condition in children. We report the successful use of veno-arterial extracorporeal membrane oxygenation (VA ECMO) as a lifesaving modality in a child with acute massive PE.
Case Presentation:
A nine-year-old female with spinal muscular atrophy type 1, chronic respiratory failure with tracheostomy and ventilator dependence presented with tachypnea and hypoxia. She had recent coiling of her pulmonary arterio-venous malformation. A chest computerized tomography scan showed massive bilateral PE. Urgent catheter-directed thrombolysis failed. She was placed on VA-ECMO with stabilization of hemodynamics. She underwent surgical thrombo-embolectomy followed by weaning of ECMO support.
Discussion:
The use of VA ECMO supported the cardio-respiratory status and perfusion to facilitate surgical embolectomy.
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