Fatal aortic thrombosis in a neonate during infusion of epsilon-aminocaproic acid

Hemorrhagic complications are common in patients placed on extracorporeal life support (ECLS), especially in those who have additional risk factors. Several centers use epsilon-aminocaproic acid (EACA) in their high-risk ECLS patients in an attempt to decrease the incidence of such complications, despite the fact that no controlled trials have been performed examining the risks and benefits of its use. The authors report the case of a neonate who had fatal aortic thrombosis during EACA administration. Also included is a discussion of the use of EACA in patients who require cardiopulmonary bypass.