Germain J F, Casadevall I, Desplanques L, De Napoli Cocci S, Hartmann J F, Mercier J C, Beaufils F
Service de Réanimation Pédiatrique Polyvalente, Hôpital Robert Debré, Paris, France.
Eur J Pediatr Surg. 1996 Apr;6(2):102-3. doi: 10.1055/s-2008-1066482.
The authors report a rare case of cannula thrombosis during extracorporeal membrane oxygenation (ECMO). A full-term newborn infant was successively placed on single-cannula veno-venous extracorporeal lung support and then on veno-arterial ECMO, because of persistent pulmonary hypertension. At 140 hours of ECMO, the infant displayed general cyanosis except in the right arm. Since asymmetric hypoxemia during ECMO may be related either to cannula malposition or to a tip thrombosis, a chest x-ray after contrast injection into the arterial line of the circuit was performed. It showed an opacification of the whole cannula but for the last distal centimeter, and of the vascular bed extending from the right subclavian artery. Cannula thrombosis was suspected and confirmed by removal of the arterial cannula. Demonstration of cannula thrombosis by opacification of the arterial line of the circuit indicates catheter removal.
作者报告了一例体外膜肺氧合（ECMO）期间罕见的插管血栓形成病例。一名足月儿因持续性肺动脉高压先后接受单插管静脉-静脉体外肺支持，然后接受静脉-动脉ECMO治疗。在ECMO治疗140小时时，婴儿除右臂外全身出现发绀。由于ECMO期间的不对称低氧血症可能与插管位置不当或尖端血栓形成有关，因此在向回路的动脉管路注入造影剂后进行了胸部X光检查。结果显示，除了最后一厘米的远端外，整个插管以及从右锁骨下动脉延伸的血管床均出现了造影剂充盈缺损。怀疑存在插管血栓形成，并通过移除动脉插管得到证实。通过回路动脉管路的造影剂充盈缺损来证实插管血栓形成表明需要移除导管。
