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European Journal of Cardio-Thoracic Surgery, Vol 9, 226-229, Copyright © 1995 by European Association for Cardio-thoracic Surgery

ARTICLES

Extracorporeal membrane oxygenation with heparin-coated systems in a 13- month-old infant with acute hypoxic respiratory failure after correction of tetralogy of Fallot

D Keh, R Rossaint, R Streich, H Gerlach, D Pappert, H Kramer and KJ Falke
Department of Anesthesiology and Intensive Care Medicine, Rudolf Virchow Clinic, Free University of Berlin, Germany.

Hemorrhagic disorders due to systemic heparinization are frequent during extracorporeal lung support (veno-venous extracorporeal membrane oxygenation: vv-ECMO). The development of heparin-coated systems has reduced the need for high-dose heparinization. Whereas the use of these heparin-coated membrane lungs and tubings has been described in former studies in adults, only few reports exist in children. This case report describes the application of a heparin-coated extracorporeal system for long-term vv-ECMO in a 13-month-old infant suffering from acute hypoxic respiratory failure after correction of tetralogy of Fallot. Only moderately elevated levels of activated clotting time (ACT, 120-160 s) and activated partial thromboplastin time (aPTT, 40-60 s) were necessary to avoid thrombotic events in the extracorporeal system. Thoracotomies were performed twice without bleeding complications by discontinuation of the systemic heparinization. We conclude that the use of heparin-coated membrane lungs in infants may improve the safety of extracorporeal lung support and permits surgical intervention without major risk of bleeding.

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				A. H Stammers, L. W Fristoe, K. Christensen, J. Deptula, R T. Sydzyik, D. Zavadil, and L. Willett Coagulopathic-induced membrane dysfunction during extracorporeal membrane oxygenation: a case report Perfusion, March 1, 1997; 12(2): 143 - 149. [Abstract] [PDF]