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Severe Pulmonary Hemorrhage in a Neonate With Hypoxic Ischemic Encephalopathy and Sepsis Managed on Extracorporeal Membrane Oxygenation
Journal article   Open access   Peer reviewed

Severe Pulmonary Hemorrhage in a Neonate With Hypoxic Ischemic Encephalopathy and Sepsis Managed on Extracorporeal Membrane Oxygenation

ASAIO journal (1992), v 68(6), pp e106-e109
01 Jun 2022
PMID: 34264871
url
https://doi.org/10.1097/mat.0000000000001520View
Published, Version of Record (VoR)Maybe Open Access (Publisher Bronze) Open

Abstract

Extracorporeal Membrane Oxygenation Hemorrhage Humans Hypoxia-Ischemia, Brain - complications Hypoxia-Ischemia, Brain - therapy Infant Infant, Newborn Respiratory Insufficiency - etiology Respiratory Insufficiency - therapy Sepsis - complications Sepsis - therapy
Pulmonary hemorrhage (PH) is an infrequent and potentially fatal event in term neonates. Reports of successful management of PH on extracorporeal membrane oxygenation (ECMO) are limited, given the accentuated risk of mortality imposed by the use of heparin to prevent thrombosis on ECMO. We present a case of a term neonate with hypoxic ischemic encephalopathy undergoing controlled hypothermia who developed hypoxic respiratory failure, hemodynamic instability, Enterobacter cloacae pneumonia and sepsis complicated by severe PH who required support with veno-arterial ECMO. We describe the therapeutic strategies used on veno-arterial ECMO to successfully manage this infant, including clamping the endotracheal tube, aggressive correction of coagulopathy, and use of dornase alfa, as well as elaborate on the subtle changes in ECMO parameters during the run that preceded worsening pneumonia with sepsis.

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Web of Science research areas
Engineering, Biomedical
Transplantation
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