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- Title
Management of severe pulmonary hemorrhage in a neonate on veno-arterial ECMO by the temporary clamping of the endotracheal tube -- a case report.
- Authors
Vobruba, Vaclav; Grus, Tomas; Mlejnsky, Frantisek; Belohlavek, Jan; Hridel, Jan; Lambert, Lukas
- Abstract
Severe pulmonary hemorrhage in the newborn is an infrequent, but life-threatening, event. A newborn with persistent pulmonary hypertension and a large persistent ductus arteriosus and open foramen ovale presented with hypoxemia and progressive right heart failure shortly after birth, requiring veno-arterial extracorporeal membrane oxygenation (ECMO) support. Twenty minutes after the initiation of ECMO, the patient developed severe pulmonary hemorrhage refractory to conventional treatment. As a last resort, the endotracheal tube was clamped. After transport to the ECMO center, repeated attempts to open the endotracheal tube resulted in continued blood loss and the endotracheal tube was clamped for a total of 63 hours without any mechanical ventilation. On the third postnatal day, the endotracheal tube was reopened, large amounts of clot were removed by bronchoscopy and mechanical ventilation was resumed followed by improved general condition and favorable outcome.
- Subjects
HYPOXEMIA; HEMORRHAGE diagnosis; HEMORRHAGE treatment; PULMONARY hypertension diagnosis; NEONATAL sepsis; ARTIFICIAL respiration; BRONCHOSCOPY; DISSEMINATED intravascular coagulation; EXTRACORPOREAL membrane oxygenation; HEART failure; HEART septum; HEMORRHAGE; LUNG diseases; MEDICAL technology; PATENT ductus arteriosus; PNEUMONIA; TREATMENT effectiveness; ENDOTRACHEAL tubes; DIAGNOSIS
- Publication
Perfusion, 2018, Vol 33, Issue 1, p77
- ISSN
0267-6591
- Publication type
Article
- DOI
10.1177/0267659117723453