SPLENIC ENLARGEMENT IN NEONATES DURING ECMO

PURPOSE: To determine whether hepatosplenomegaly was a reproducible fi nding in seven neonates who were being treated with extracorporeal mem brane oxygenation (ECMO) for respiratory failure. MATERIALS AND METHOD S: 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 calcu lated by using published formulas. RESULTS: Splenic volume increased i n all seven patients from 8.3 cm(3) +/- 1.7 to 16.4 cm(3) +/- 4.4 (P l ess than or equal to .001). Hepatic size did not change markedly. CONC LUSION: Hemolysis, leukopenia, and platelet activation occur during EC MO. Rapid splenic enlargement may be secondary to sequestration of red cells, platelets, and other hematologic elements that have been damag ed in the ECMO circuit. Since the liver does not also increase in size , the splenic enlargement is unlikely to be the result of passive cong estion.