Logo image
ECMO as a Platform for Rapid Ammonia Removal in a Neonate with Multienzyme Urea Cycle Disorder
Journal article

ECMO as a Platform for Rapid Ammonia Removal in a Neonate with Multienzyme Urea Cycle Disorder

Kelechi Ikeri, Vilmaris Quinones Cardona, Abena Hagan-Brown, Megan Young, Michael Schneider, Ogechukwu Menkiti and Megan Schneider
The Journal of extra-corporeal technology, v 52(1)
Mar 2020
PMID: 32280145

Abstract

Adult Ammonia Cesarean Section Extracorporeal Membrane Oxygenation Female Humans Infant, Newborn Pregnancy Respiratory Insufficiency Urea Cycle Disorders, Inborn
Since the initial deployment of neonatal extracorporeal membrane oxygenation (ECMO) for respiratory failure, the use of ECMO in this population has diversified. We present a term female infant with carbamoyl phosphate synthetase 1 and partial N-acetylglutamate synthase deficiencies who developed severe hyperammonemia refractory to medical management requiring venoarterial ECMO-driven continuous veno-venous hemodiafiltration for ammonia detoxification. This case report illustrates a subpopulation where neonatal ECMO may improve survival and neurodevelopmental outcomes. To our knowledge, this is the first reported case of a urea cycle defect arising from two proximal enzyme deficiencies. Also, this is one of the few reported patients with UCD associated with peak ammonia levels >2,000 μmol/L who survived to hospital discharge after the successful use of ECMO for ammonia reduction. This case will add to the existing scant literature supporting the use of ECMO as a platform for rapid removal of serum ammonia.

Metrics

19 Record Views

Details

Logo image