title: [Complications of critically ill children supported by venoarterial extracorporeal membrane oxygenation].
abstract: OBJECTIVE
  To study the complications occurred in the process of venoarterial extracorporeal membrane oxygenation (VA-EMCO) in critically ill children.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors: Pediatric Intensive Care Unit, Children's Hospital of Fudan University, Shanghai 201102, China.
authors: Y
authors: Y
authors: Cheng
authors: Z J
authors: ZJ
authors: Lu
authors: X G
authors: XG
authors: Yan
authors: J
authors: J
authors: He
authors: G F
authors: GF
authors: Yan
authors: X D
authors: XD
authors: Cai
authors: W J
authors: WJ
authors: Shen
authors: A L
authors: AL
authors: Jin
authors: G P
authors: GP
authors: Lu
mesh_terms: D002544:Cerebral Infarction; D002648:Child; D016638:Critical Illness; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006470:Hemorrhage; D006801:Humans; D008297:Male; D010351:Patient Discharge; D012189:Retrospective Studies; D012640:Seizures; D013927:Thrombosis