Subdural extravasation of crystalloids and blood products through a scalp peripheral intravenous catheter into the subdural space of a neonate on veno-arterial extracorporeal membrane oxygenation

2021 ◽  
pp. 1-5
Author(s):  
N. Fleiss ◽  
R. Klein-Cloud ◽  
B. Gill ◽  
N.A. Feldstein ◽  
E.M. Fallon ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Subdural Space ◽  
Blood Products ◽  
Midline Shift ◽  
Increased Intracranial Pressure ◽  
Intravenous Catheter ◽  
Hemodynamic Changes ◽  
Membrane Oxygenation ◽  
Routine Surveillance ◽  
Peripheral Intravenous Catheter

We describe a rare and devastating complication of a malpositioned scalp peripheral intravenous catheter (PIV) that resulted in subdural extravasation of infused fluids and midline shift in a critically ill neonate who required extracorporeal membrane oxygenation (ECMO). Recognition of increased intracranial pressure was hindered by the hemodynamic changes of being on ECMO and only identified by routine surveillance ultrasonography. Awareness of this complication may lead providers to seek alternate sites for vascular access in such patients, and encourage closer monitoring for this complication when an alternate site is unavailable.

scholarly journals Personalized blood products in neonatal extracorporeal membrane oxygenation: the path between protocols and mortality

2021 ◽  
Vol 6 ◽  
pp. 10-10
Author(s):  
Luigia Ocello ◽  
Gennaro Martucci ◽  
Marcello Piazza ◽  
Antonio Arcadipane
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Blood Products ◽  
Membrane Oxygenation

Hemodynamic changes during opening of the bridge in venoarterial extracorporeal membrane oxygenation

2001 ◽  
Vol 2 (3) ◽  
pp. 265-270 ◽  
Author(s):  
Arno van Heijst ◽  
Djien Liem ◽  
Frans van der Staak ◽  
John Klaessens ◽  
Cees Festen ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Hemodynamic Changes ◽  
Membrane Oxygenation ◽  
Venoarterial Extracorporeal Membrane Oxygenation

scholarly journals Epidemiology of the Use of Hemostatic Agents in Children Supported by Extracorporeal Membrane Oxygenation: A Pediatric Health Information System Database Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Marianne E. Nellis ◽  
Ljiljana V. Vasovic ◽  
Ruchika Goel ◽  
Oliver Karam
Keyword(s):  
Information System ◽  
Extracorporeal Membrane Oxygenation ◽  
Health Information ◽  
Factor Viia ◽  
Health Information System ◽  
Aminocaproic Acid ◽  
Blood Products ◽  
Pediatric Health ◽  
Hemostatic Agents ◽  
Membrane Oxygenation

Objectives: Children supported by extracorporeal membrane oxygenation (ECMO) are at high risk of bleeding. Though practitioners often prescribe blood components and/or medications to prevent or treat bleeding, the utilization of these hemostatic measures in children is not well-understood. We sought to evaluate the use of hemostatic blood products (platelet, plasma and cryoprecipitate transfusions) and medications [aminocaproic acid, tranexamic acid (TXA) and Factor VIIa] in children supported by ECMO.Design: Retrospective observational study using the Pediatric Health Information System (PHIS) database from 2011-2017.Setting: Fifty-one U.S. children's hospitals.Patients: Children (aged 0–18 years) supported by ECMO.Interventions: None.Measurements and Main Results: ECMO was employed in the care of 7,910 children for a total of 56,079 ECMO days. Fifty-five percent of the patients were male with a median (IQR) age of 0 (0–2) years. The median (IQR) length of ECMO was 5 (2–9) days with a hospital mortality rate of 34%. Platelets were transfused on 49% of ECMO days, plasma on 33% of ECMO days and cryoprecipitate on 17% of ECMO days. Twenty-two percent of children received TXA with the majority receiving it on the first day of ECMO and the use of TXA increased during the 6-year period studied (p < 0.001). Seven percent of children received aminocaproic acid and 3% received Factor VIIa.Conclusions: Children supported by ECMO are exposed to a significant number of hemostatic blood products. Antifibrinolytics, in particular TXA, are being used more frequently. Given the known morbidity and mortality associated with hemostatic blood products, studies are warranted to evaluate the effectiveness of hemostatic strategies.

Increased blood transfusion and its impact in patients having tracheostomy while on extracorporeal membrane oxygenation

Perfusion ◽  
2018 ◽  
Vol 34 (2) ◽  
pp. 143-146 ◽  
Author(s):  
Dwight D. Harris ◽  
Alexis E. Shafii ◽  
Maher Baz ◽  
Thomas A. Tribble ◽  
Victor A. Ferraris
Keyword(s):  
Blood Loss ◽  
Extracorporeal Membrane Oxygenation ◽  
Blood Products ◽  
Inclusion Criteria ◽  
Total Blood ◽  
Membrane Oxygenation ◽  
Venovenous Extracorporeal Membrane Oxygenation ◽  
The Impact ◽  
Complications And Mortality ◽  
Vv Ecmo

Introduction: Tracheostomy has been utilized in combination with venovenous extracorporeal membrane oxygenation (VV-ECMO) to enable early spontaneous breathing and minimize sedation requirements. Tracheostomy has been previously reported to be safe in patients supported on VV-ECMO; however, the impact of tracheostomy on blood loss in VV-ECMO patients is unknown. Methods: We analyzed VV-ECMO patients with and without tracheostomy over a 5-year period. In order to avoid other potential sources of blood loss not related to tracheostomy or ECMO-related blood loss, patients who underwent a recent surgery prior to ECMO or during ECMO (other than tracheostomy) were excluded. Results: Sixty-three patients meeting the inclusion criteria were identified (tracheostomy n=30, non-tracheostomy n=33). Tracheostomy patients were found to require more daily transfusions of red blood cells (RBC) (0.47 [0.20-1.0] vs. 0.23 [0.06-0.40] units/day, p=0.02) and total blood products (0.60 [0.32-1.0] vs. 0.31 [0.10-0.50] units/day, p=0.01). Conclusions: These results suggest that tracheostomy while on VV-ECMO predisposes patients to increased transfusion burden. Based on previous research, this increased transfusion burden could potentially be linked to increased complications and mortality.

scholarly journals Transfusion of blood products during extracorporeal membrane oxygenation: a narrative review of rationale, indications, impact on immune function and outcome

2021 ◽  
Vol 0 ◽  
pp. 0-0
Author(s):  
Antonio Siragusa ◽  
Clarissa Forlini ◽  
Benedetta Fumagalli ◽  
Simone Redaelli ◽  
Dario Winterton ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Immune Function ◽  
Narrative Review ◽  
Blood Products ◽  
Membrane Oxygenation

scholarly journals Multislice CT Scans in Patients on Extracorporeal Membrane Oxygenation: Emphasis on Hemodynamic Changes and Imaging Pitfalls

2014 ◽  
Vol 15 (3) ◽  
pp. 322 ◽  
Author(s):  
Kao-Lang Liu ◽  
Yu-Feng Wang ◽  
Yeun-Chung Chang ◽  
Shu-Chien Huang ◽  
Shyh-Jye Chen ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Multislice Ct ◽  
Ct Scans ◽  
Hemodynamic Changes ◽  
Membrane Oxygenation ◽  
Imaging Pitfalls

Extracorporeal membrane oxygenation support after heart- or lungtransplantation

2011 ◽  
Vol 59 (S 01) ◽  
Author(s):  
A Mühle ◽  
G Färber ◽  
T Doenst ◽  
M Barten ◽  
J Garbade ◽  
...  
Keyword(s):  
Extracorporeal Membrane Oxygenation ◽  
Membrane Oxygenation
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