scholarly journals Inferior vena cava thrombosis during extracorporeal membrane oxygenation: a case report and review of the literature

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
YouLian Chen ◽  
HuaiSheng Chen ◽  
XueYan Liu ◽  
ChengYing Hong ◽  
HuaDong Zhang
Keyword(s):  
Inferior Vena Cava ◽  
Extracorporeal Membrane Oxygenation ◽  
Anticoagulant Therapy ◽  
Inferior Vena ◽  
Rare Complication ◽  
Vena Cava ◽  
Membrane Oxygenation ◽  
Cardiopulmonary Support ◽  
Ivc Thrombosis ◽  
Ecmo Therapy

Abstract Background Extracorporeal membrane oxygenation (ECMO) is an effective cardiopulmonary support therapy, which can provide temporary cardiopulmonary support for critically ill patients whose condition cannot be reversed by conventional therapy. However, there are many complications in the use of ECMO, such as bleeding, thrombosis, and so on. Among them, inferior vena cava (IVC) thrombosis which can cause pulmonary embolism is a rare complication, which may be life-threatening. Case presentation A 75-year-old female patient (Han Chinese ethnicity) with acute heart failure due to acute myocardial infarction in our department was retrospectively analyzed. After regular treatment was unsuccessful, she was treated with venoarterial ECMO (VA-ECMO). After her condition improved, she was withdrawn from ECMO and experienced a complication of IVC thrombosis. Enoxaparin was given immediately for 1 mg/kg every 12 hours hypodermic injection. The thrombus disappeared after anticoagulant therapy. She was discharged on the 60th day. Her level of consciousness returned to normal without residual central nervous system-related complications. Conclusions IVC thrombosis is one of the possible serious complications in the process of ECMO therapy. Prevention of thrombosis and optimization of the anticoagulant regimen are the main preventive measures. Anticoagulant therapy is still the main treatment of IVC thrombosis in the process of ECMO therapy. Other interventional strategies need to accumulate clinical experience.

Optimal drainage cannula position in dual cannulation for veno-venous extracorporeal membrane oxygenation

2018 ◽  
Vol 41 (12) ◽  
pp. 867-871 ◽  
Author(s):  
Konomi Togo ◽  
Yoshiaki Takewa ◽  
Nobumasa Katagiri ◽  
Yutaka Fujii ◽  
Akihiro C Yamashita ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Extracorporeal Membrane Oxygenation ◽  
Superior Vena Cava ◽  
Right Atrium ◽  
Inferior Vena ◽  
Superior Vena ◽  
Vena Cava ◽  
Arterial Oxygen ◽  
Membrane Oxygenation ◽  
Recirculation Fraction

Introduction: Recently, the use of veno-venous extracorporeal membrane oxygenation for adult patients with severe acute respiratory failure has increased. We previously investigated the optimal return cannula position; however, the optimal drainage cannula position has not yet been fully clarified. The aim of this study was to investigate the optimal drainage cannula position. Methods: Veno-venous extracorporeal membrane oxygenation was performed in four adult goats (mean body weight 59.6 ± 0.6 kg). The position of the drainage cannula was varied among the right atrium, the upper inferior vena cava, and the lower inferior vena cava, whereas the position of the return cannula was fixed in the superior vena cava. The recirculation fraction and arterial oxygen saturation and pressure (SaO2, PaO2) were measured in all drainage cannula positions. Results: In the lower inferior vena cava drainage cannula position, the recirculation fraction was the lowest. In the lower inferior vena cava, upper inferior vena cava, and right atrium drainage cannula positions at 3 L/min, SaO2 and PaO2 after 20 min were 92.9% ± 4.9% and 75.1 ± 26.0 mm Hg, 99.5% ± 0.5% and 113.8 ± 20.9 mm Hg, and 93.8% ± 6.2% and 91.9 ± 17.7 mm Hg, respectively. Conclusion: With respect to blood oxygenation, the optimal position for the drainage cannula was the upper inferior vena cava. These findings suggested that blood from the superior vena cava, inferior vena cava, and hepatic vein was most efficiently drained in the upper inferior vena cava cannula position.

Sign in / Sign up

Export Citation Format

Share Document