Splenic enlargement in neonates during ECMO.
OBJECTIVE
To determine whether hepatosplenomegaly was a reproducible finding in seven neonates who were being treated with extracorporeal membrane oxygenation (ECMO) for respiratory failure.


METHODS
The authors measured splenic and hepatic dimensions with ultrasound (US) at the time ECMO was initiated and then every 24-48 hours until decannulation. Splenic volume and the index of hepatic size were calculated by using published formulas.


RESULTS
Splenic volume increased in all seven patients from 8.3 cm3 +/- 1.7 to 16.4 cm3 +/- 4.4 (P < or = .001). Hepatic size did not change markedly.


CONCLUSIONS
Hemolysis, leukopenia, and platelet activation occur during ECMO. Rapid splenic enlargement may be secondary to sequestration of red cells, platelets, and other hematologic elements that have been damaged in the ECMO circuit. Since the liver does not also increase in size, the splenic enlargement is unlikely to be the result of passive congestion.
Klippenstein
D L
DL
Department of Radiology, University of Michigan Hospitals, Ann Arbor.
Zerin
J M
JM
Hirschl
R B
RB
Donn
S M
SM
D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D012131:Respiratory Insufficiency / Q000628:therapy; D013154:Spleen / Q000000981:diagnostic imaging; D013163:Splenomegaly / Q000000981:diagnostic imaging / Q000209:etiology*; D014463:Ultrasonography