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Related Experiment Videos

Coagulopathic-induced membrane dysfunction during extracorporeal membrane oxygenation: a case report

A H Stammers1, L W Fristoe, K Christensen

  • 1Division of Clinical Perfusion Education, University of Nebraska Medical Center, Omaha 68198-5155, USA.

Perfusion
|March 1, 1997
PubMed
Summary

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This case report details a rare complication of extracorporeal membrane oxygenation (ECMO) in a neonate with respiratory distress. Membrane dysfunction and coagulopathy developed, leading to circuit clotting and patient demise despite intensive support.

Area of Science:

  • Neonatal Medicine
  • Cardiovascular Surgery
  • Critical Care Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a life-support technique for severe neonatal respiratory failure.
  • Neonatal respiratory distress, particularly primary pulmonary hypertension, necessitates advanced respiratory support.
  • Consumptive coagulopathy is a known risk during prolonged ECMO support.

Observation:

  • A term infant with primary pulmonary hypertension developed severe respiratory distress requiring veno-arterial ECMO.
  • During ECMO, the patient experienced a consumptive coagulopathy with significant drops in platelet count and fibrinogen.
  • Increased transmembrane pressure and transfusion requirements preceded the coagulopathy and circuit clotting.

Findings:

  • Post-ECMO circuit analysis revealed significant clots within the oxygenator and venous bladder.

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  • A fused, desiccated clot pattern obstructed the membrane compartment, disrupting blood flow.
  • The findings suggest ECMO oxygenator membrane dysfunction secondary to coagulopathy.

    • Implications:

    • This case highlights an unusual ECMO oxygenator complication related to coagulopathy during long-term support.
    • Understanding and preventing such membrane dysfunctions are crucial for improving ECMO outcomes.
    • Further research into optimizing anticoagulation and circuit management in neonates is warranted.