Table 5.
Complications during ECMO support *).
| Respiratory | |
| Pneumothorax – n (%) # | 3 (30) |
| Persistent hypoxemia – n (%) §) | 3 (30) |
| Gastrointestinal | |
| Hypoxic hepatitis – n (%) ¶ | 5 (50) |
| Digestive hemorrhage – n (%) | 2 (20) |
| Hematological | |
| Hemolysis ®) | 3 (30) |
| Thrombocytopenia (<150000) – n (%) | 9 (90) |
| Thrombocytopenia (<100000) – n (%) | 8 (80) |
| Thrombocytopenia (<50000) – n (%) | 7 (70) |
| ECMO system | |
| Minor canulae bleeding – n (%)©) | 2 (20) |
| Flowmeter loss of signal – n (%) | 2 (20) |
| Blood leakage – n (%) | 0 (0) |
| Re-circulation – n (%) ¥ | 1 (10) |
| Centrifugal pump cavitation – n (%) £ | 1 (10) |
| Shaking circuit – n (%) £ | 1 (10) |
| Sudden reduction in blood flow – n (%) £ | 3 (20) |
| Central nervous system | |
| Seizure – n (%) | 2 (20) |
| Brain death – n (%) | 1 (10) |
ECMO denotes extracorporeal membrane oxygenation.
# The pneumothoraxes occurred at the end of ECMO support in all patients.
Persistent hypoxemia was defined as a PaO2≤50 mmHg despite an ECMO blood flow >5500 L/minute, a PEEP≥10 cmH2O and a FiO2≥0.6.
¶ Hypoxic hepatitis was diagnosed when alanine transaminase and aspartate aminotransferase were acutely elevated by at least five-fold soon after the initiation of ECMO support.
Hemolysis was considered in patients who had brown urine, brown effluent fluid from renal replacement therapy and/or a haptoglobin level<36 mg/dL (low limit of normality in our laboratory).
Sufficient bleeding to require a cannula insertion dressing change more than twice a day.
¥ Re-circulation was considered when persistent hypoxemia occurred with ECMO system drainage and an oxygen blood saturation of<70%.
£ Centrifugal pump cavitation, a shaking circuit and a sudden decrease in blood flow constitute the “suck-up” phenomena, which are secondary to the pre-pump lower pressure associated with drainage cannula misplacement or hypovolemia.