Sudden dysfunction of veno-venous extracorporeal membrane oxygenation caused by intermittent cannula obstruction: the key role of echocardiography

Ruisánchez, Cristina; Sarralde, J.A.; González-Fernández, Camilo; Domínguez, M.

doi:10.1007/s00134-017-4704-5

Cited by 8 publications

(6 citation statements)

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“…The PubMed database was searched by using the keywords "inferior vena cava thrombosis" and "extracorporeal membrane oxygenation." Our search showed 13 other reports on the subject (Table 1) [7][8][9][10][11][12][13][14][15][16][17][18]. Among the 14 patients, five patients were treated with VA-ECMO, mainly cardiogenic shock patients, including one heart transplant patient; the other eight patients were treated with veno-venous ECMO (VV-ECMO) after acute respiratory failure, including two lung transplant patients.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of death was not caused by pulmonary embolism, which may be related to the severity of the disease. According to the literature, the causes of IVC thrombosis are as follows: blood loss, insufficient volume, decreased blood flow velocity [14], continuous catheter shaking, low-intensity anticoagulation, or no heparin anticoagulation, all of which are also important reasons for thrombosis on the surface of ECMO catheter. In addition, because there is no heparin coating on the outer surface of the ECMO catheter, thrombosis is more likely to occur.…”

Section: Discussionmentioning

confidence: 99%

“…The clinical manifestations of IVC thrombosis in ECMO patients were nonspecific, mainly manifested as "IVC syndrome," and distal limb edema in some patients after removal of the ECMO catheter [13]. In addition, if IVC thrombosis occurs during ECMO, sudden hypoxemia and ECMO flow decrease may also be caused by the patient's postural changes [14]. Hemolysis has also been reported [15].…”

Section: Discussionmentioning

confidence: 99%

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Inferior vena cava thrombosis during extracorporeal membrane oxygenation: a case report and review of the literature

Chen

Liu

et al. 2021

J Med Case Reports

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Background Extracorporeal membrane oxygenation (ECMO) is an effective cardiopulmonary support therapy, which can provide temporary cardiopulmonary support for critically ill patients whose condition cannot be reversed by conventional therapy. However, there are many complications in the use of ECMO, such as bleeding, thrombosis, and so on. Among them, inferior vena cava (IVC) thrombosis which can cause pulmonary embolism is a rare complication, which may be life-threatening. Case presentation A 75-year-old female patient (Han Chinese ethnicity) with acute heart failure due to acute myocardial infarction in our department was retrospectively analyzed. After regular treatment was unsuccessful, she was treated with venoarterial ECMO (VA-ECMO). After her condition improved, she was withdrawn from ECMO and experienced a complication of IVC thrombosis. Enoxaparin was given immediately for 1 mg/kg every 12 hours hypodermic injection. The thrombus disappeared after anticoagulant therapy. She was discharged on the 60th day. Her level of consciousness returned to normal without residual central nervous system-related complications. Conclusions IVC thrombosis is one of the possible serious complications in the process of ECMO therapy. Prevention of thrombosis and optimization of the anticoagulant regimen are the main preventive measures. Anticoagulant therapy is still the main treatment of IVC thrombosis in the process of ECMO therapy. Other interventional strategies need to accumulate clinical experience.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Inferior vena cava thrombosis during extracorporeal membrane oxygenation: a case report and review of the literature

Chen

Liu

et al. 2021

J Med Case Reports

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“…Thrombosis is a major complication that leads to low flow in ECMO, and TEE is considered to be one of the most important tools for proper assessment and diagnosis of this complication. 5 Thorough examination using TEE can lead to accurate diagnosis of underlying problems.…”

Section: Discussionmentioning

confidence: 99%

Management of a bi-caval dual lumen cannula clot obstruction after TEE guided diagnosis: a case report

Zamper

Bainbridge

Nagpal

et al. 2020

Brazilian Journal of Anesthesiology (English Edition)

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“…Generally, BSI increases circuit clotting, leading to mechanical dysfunction of the ECMO circuit, [4][5][6] and is associated with poor outcomes, including increased morbidity and mortality, longer duration of ECMO and mechanical ventilation, and longer stays in the intensive care unit (ICU) and general hospital. 7,8 In this context, an investigation of the association between oxygenator colonization and clinical outcomes and related factors is required.…”

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confidence: 99%

Microbial Colonization of Oxygenator and Clinical Outcomes in Extracorporeal Membrane Oxygenation

et al. 2021

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The importance of microbial colonization during extracorporeal membrane oxygenation (ECMO) is unclear. We prospectively cultured ECMO oxygenators and retrospectively reviewed the culture results, clinical outcomes, and associated factors in 112 ECMO patients (122 oxygenators, 1,196 ECMO days). Of the oxygenators, 11.6% (n = 13) had positive cultures. The most common pathogen was Klebsiella pneumoniae, followed by Acinetobacter baumannii and Staphylococcus epidermidis. Nine (69%) cases showed catheter colonization, and five (38%) bloodstream infection (BSI) with the same microorganism. Most of the microorganisms were multidrug resistant. BSI tended to be associated with oxygenator colonization (r = 0.172, p = 0.070). The patients were divided into oxygenator colonization (n = 13) and no colonization groups (n = 99). Successful weaning from ECMO and survival to discharge were significantly lower in the oxygenator colonization group (weaning 30.8% vs. 90.9%, p < 0.001, survival 23.1% vs. 76.8%; p < 0.001). In multivariate analyses, age (per decade) (odds ratio [OR] = 1.95, 95% CI = 1.28–2.95; p = 0.002), oxygenator colonization (OR = 15.49, 95% CI = 3.31–72.46; p < 0.001), and renal replacement therapy (OR = 4.61, 95% CI = 1.69–12.58; p = 0.003) were significantly associated with mortality. Oxygenator colonization was associated with poor outcomes in ECMO patients. These results support the early exchange and culture of oxygenators in patients with persisting bacteremia.

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Sudden dysfunction of veno-venous extracorporeal membrane oxygenation caused by intermittent cannula obstruction: the key role of echocardiography

Cited by 8 publications

References 0 publications

Inferior vena cava thrombosis during extracorporeal membrane oxygenation: a case report and review of the literature

Inferior vena cava thrombosis during extracorporeal membrane oxygenation: a case report and review of the literature

Management of a bi-caval dual lumen cannula clot obstruction after TEE guided diagnosis: a case report

Microbial Colonization of Oxygenator and Clinical Outcomes in Extracorporeal Membrane Oxygenation

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