Tiruvoipati et al listed various complications occurring in neonates receiving extracorporeal membrane oxygenation (ECMO) therapy. This therapy is not without risks and the decision makers for the neonate need to informed of these potential complications. The authors are from Glenfield Hospital and the University of Nottingham in England.


ECMO device problems:

(1) thrombosis and/or air in circuit

(2) tubing problems (cracks. etc)

(3) malfunction of the oxygenator

(4) malfunction of the blood pump

(5) problems affecting the cannulae (thrombosis, poor flow, etc)


Adverse effects on the neonate:

(1) central nervous system complications

(1a) seizures

(1b) intraventricular hemorrhage

(1c) cerebral infarction

(2) gastrointestinal hemorrhage

(3) infection

(3a) vascular line infection

(3b) sepsis

(4) renal dysfunction

(5) respiratory dysfunction

(5a) pneumothorax

(5b) pulmonary hemorrhage

(5c) pulmonary emboli

(6) cardiovascular dysfunction

(6a) hypotension or hypertension

(6b) cardiopulmonary arrest

(6c) cardiac arrhythmias

(6d) thromboemboli

(7) bleeding from surgical site, vascular access points, etc


The adverse effects can be viewed as forms of multi-organ failures (MOF).


Interventions to address some of these problems may include:

(1) change of an ECMO component

(2) blood pressure control (inotropes or antihypertensives)

(3) venovenous hemofiltration

(4) ventilatory support

(5) blood transfusion

(6) anti-arrhythmic agents

(7) antibiotics

(8) adjusting anticoagulation therapy


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