A potential propensity for failure secondary to clot embolism in neonatal ECMO
| Autor: | Andrzej W. Sosnowski, Espeed Khoshbin, David Machin, Richard K. Firmin, Hilliary M. Killer, Giles J. Peek |
|---|---|
| Rok vydání: | 2005 |
| Předmět: |
medicine.medical_specialty
Oxygenators medicine.medical_treatment 030204 cardiovascular system & hematology Treatment failure Sepsis 03 medical and health sciences Extracorporeal Membrane Oxygenation Fatal Outcome 0302 clinical medicine Thromboembolism Influenza Human medicine Extracorporeal membrane oxygenation Humans Radiology Nuclear Medicine and imaging Treatment Failure Oxygenator Oxygenators Membrane Advanced and Specialized Nursing Platelet Count business.industry Infant Newborn Influenza a Equipment Design Pneumonia General Medicine medicine.disease Surgery Equipment failure 030228 respiratory system Embolism Anesthesia Equipment Failure Female Cardiology and Cardiovascular Medicine business Safety Research |
| Zdroj: | Perfusion. 20:177-181 |
| ISSN: | 1477-111X 0267-6591 |
| DOI: | 10.1191/0267659105pf798cs |
| Popis: | Objective: To report a single case of oxygenator failure caused by clot embolism originating from the bladder; and to discuss some preventative options. Case report: A 2.5 kg neonate with a diagnosis of influenza A received veno-arterial (V / A) extracorporeal membrane oxygenation (ECMO) for cardiorespiratory support. Halfway through treatment, she underwent an elective circuit change for numerous clots in her circuit. The patient continued to consume vast quantities of platelets and developed a fatal oxygenator failure after 18 days. Discussion: Amongst the factors influencing the outcome in events of a sudden unexpected oxygenator failure are the severity of patient illness, the size of the clot relative to the size of the oxygenator, the availability of a previously primed circuit and the ease and speed of priming a new oxygenator. Conclusion: There is a need for improvement in the design of small oxygenators and ECMO circuits. Adjustment of the coagulation parameters and lowering the tolerance towards clots in the circuit by electively changing them may reduce the incidence of sudden unexpected oxygenator failure. However, using a slightly larger Medos oxygenator may gain valuable time needed to arrange an oxygenator/circuit change. |
| Databáze: | OpenAIRE |
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