Adrenal hemorrhage in infants undergoing ECMO: prevalence and clinical significance.

OBJECTIVE

To determine the prevalence and clinical significance of adrenal hemorrhage in infants undergoing ECMO therapy.

METHODS

Prospective US evaluation of the adrenal glands was performed in 50 consecutive infants undergoing ECMO. The infants were examined at least every other day while on bypass. Adrenal hemorrhage was diagnosed at US examination when a suprarenal mass or adrenal gland enlargement was identified.

RESULTS

Adrenal hemorrhage was identified in two infants (4%); one infant with septicemia, and one with primary pulmonary hypertension. Both hemorrhages were unilateral; one was right-sided, and one left-sided. One hemorrhage occurred on the first day following the onset of ECMO and the other on the third day. The adrenal hemorrhage was not associated with an acute drop in hematocrit nor with adrenal insufficiency in either infant.

CONCLUSION

Adrenal hemorrhage is uncommon in infants undergoing ECMO. When hemorrhage did occur in this series, it did not result in clinical complications.