[Complications of critically ill children supported by venoarterial extracorporeal membrane oxygenation].

OBJECTIVE: To study the complications occurred in the process of venoarterial extracorporeal membrane oxygenation (VA-EMCO) in critically ill children.

METHOD: To analyze retrospectively 25 children who were admitted to PICU of Children's Hospital of Fudan University from December 2011 to December 2015. They were all treated with VA-ECMO with incision and catheterization in right internal carotid artery and jugular vein. Complications were recorded during ECMO process.

RESULT: The duration of ECMO treatment was 14 to 567 h (153 (112, 204) h). Seventeen cases (68%) withdrew from ECMO successfully and 15 cases (60%) survived to discharge. Thirty-three complications occurred during ECMO treatment. Of which, mechanical complications occurred 9 times, including oxygenator leakage (n=3), hemolysis (n=2), water tank failure (n=2), pump head rupture (n=1) and piping thrombosis (n=1). Somatic complications appeared 24 times, including neurological complications (n=8) which included cerebral infarction (n=2), convulsions (n=2), intracranial hemorrhage (n=2), thrombosis after ligation of internal jugular vein (n=1) and cerebral atrophy (n=1); bleeding complications (n=8) which included bleeding at puncture sites (n=4), ECMO canalized site bleeding (n=3), and spontaneous (n=1), intracranial hemorrhage or hematoma cases(n=2) in mechanical complications; acute kidney injury (n=5) and microcirculation thrombosis (n=3).

CONCLUSION: ECMO technique may cause complications, which mainly include neurological, mechanical and clotting complications. Advanced equipments and materials and well-managed teamwork are helpful in decreasing complications.