THROMBOSIS OF THE ARTERIAL CANNULA DURING EXTRACORPOREAL MEMBRANE-OXYGENATION IN A FULL-TERM NEWBORN-INFANT

The authors report a rare case of cannula thrombosis during extracorpo real membrane oxygenation (ECMO). A full-term newborn infant was succe ssively placed on single-cannula veno-venous extracorporeal lung suppo rt and then on veno-arterial ECMO, because of persistent pulmonary hyp ertension. At 140 hours of ECMO, the infant displayed general cyanosis except in the right arm. Since asymmetric hypoxemia during ECMO may b e related either to cannula malposition or to a tip thrombosis, a ches t x-ray after contrast injection into the arterial line of the circuit was performed. It showed an opacification of the whole cannula but fo r the last distal centimeter, and of the vascular bed extending from t he right subclavian artery Cannula thrombosis was suspected and confir med by removal of the arterial cannula. Demonstration of cannula throm bosis by opacification of the arterial line of the circuit indicates c atheter removal.