A pediatric VA-ECMO case of difficulty in choosing the cannula size

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  • 小児VA-ECMO症例における送脱血管径の選択に難渋した一症例

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Abstract

<p>We experienced a pediatric veno-arterial extracorporeal membrane oxygenation (VA-ECMO) case, which developed insufficient perfusion flow induced by poor blood removal because of small canulae for body size. A 7 years old girl, 107 cm of height and 24 kg of body weight, was admitted to ICU under mechanical ventilation after an emergent neurosurgical procedure. Five hours later, she developed ventricular fibrillation and required resuscitation. The resuscitation needed VA-ECMO and 8 Fr arterial cannula and 10 Fr venous cannula were inserted at right femoral artery and left femoral vein, respectively. However, just insufficient perfusion flow was established because of poor venous drainage (around 1 L/min). Consequently, she died 30 hours after the ECMO establishment. Although it is not easy to choose appropriate size and site for ECMO cannulation especially for pediatric cases, it may be important to create more options in order to maintain and establish appropriate ECMO circulation.</p>

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