Extracorporeal membrane oxygenation-related spinal cord infarction: A case report
Extracorporeal membrane oxygenation (ECMO) is a high-risk extracorporeal technique that serves as an effective last-ditch salvage therapy for patients with severe heart or respiratory failure. The most common complications observed after ECMO include hypoxic and vascular lesions (ischemic or hemorrh...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-03-01
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| Series: | Interdisciplinary Neurosurgery |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214751920305892 |
| _version_ | 1818616282412482560 |
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| author | Shih-Chao Chien Li-Kuo Kuo Shih-Chun Chien Yu-Jang Su |
| author_facet | Shih-Chao Chien Li-Kuo Kuo Shih-Chun Chien Yu-Jang Su |
| author_sort | Shih-Chao Chien |
| collection | DOAJ |
| description | Extracorporeal membrane oxygenation (ECMO) is a high-risk extracorporeal technique that serves as an effective last-ditch salvage therapy for patients with severe heart or respiratory failure. The most common complications observed after ECMO include hypoxic and vascular lesions (ischemic or hemorrhagic). Neurologic complications contribute to a proportion of post-treatment morbidity and mortality but have seldom been well described. We present the case of a 26-year-old man with complications related to influenza A pneumonia and who experienced sudden-onset paraplegia after undergoing ECMO. A magnetic resonance imaging scan revealed spinal infarction at the T9 to L1 level, likely involving the artery of Adamkiewicz. This may be attributed to spinal hypoperfusion or thromboembolism. Similar previously reported cases show a large variation in the ECMO duration; however, the venoarterial mode of ECMO was commonly used in cases involving this complication. Although spinal infarction is rarely reported to occur in clinical practice after ECMO complications, it requires a high index of suspicion for recognition. Close monitoring of coagulation and platelet count and electrophysiological recording during ECMO may be useful in early detection and prevention of complications. |
| first_indexed | 2024-12-16T16:47:19Z |
| format | Article |
| id | doaj.art-fb5582891c5b4f27a556f54a53f1a625 |
| institution | Directory Open Access Journal |
| issn | 2214-7519 |
| language | English |
| last_indexed | 2024-12-16T16:47:19Z |
| publishDate | 2021-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Interdisciplinary Neurosurgery |
| spelling | doaj.art-fb5582891c5b4f27a556f54a53f1a6252022-12-21T22:24:08ZengElsevierInterdisciplinary Neurosurgery2214-75192021-03-0123101028Extracorporeal membrane oxygenation-related spinal cord infarction: A case reportShih-Chao Chien0Li-Kuo Kuo1Shih-Chun Chien2Yu-Jang Su3Department of Emergency Medicine, Mackay Memorial Hospital, Taipei City, TaiwanDepartment of Critical Care Medicine, Mackay Memorial Hospital, Taipei City, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taipei City, TaiwanDepartment of Emergency Medicine, Mackay Memorial Hospital, Taipei City, TaiwanDepartment of Emergency Medicine, Mackay Memorial Hospital, Taipei City, Taiwan; Department of Medicine, Mackay Medical College, New Taipei City, Taipei City, Taiwan; Corresponding author at: No. 92, Sec 2, North Chung Shan Rd., Taipei 10449, Taiwan.Extracorporeal membrane oxygenation (ECMO) is a high-risk extracorporeal technique that serves as an effective last-ditch salvage therapy for patients with severe heart or respiratory failure. The most common complications observed after ECMO include hypoxic and vascular lesions (ischemic or hemorrhagic). Neurologic complications contribute to a proportion of post-treatment morbidity and mortality but have seldom been well described. We present the case of a 26-year-old man with complications related to influenza A pneumonia and who experienced sudden-onset paraplegia after undergoing ECMO. A magnetic resonance imaging scan revealed spinal infarction at the T9 to L1 level, likely involving the artery of Adamkiewicz. This may be attributed to spinal hypoperfusion or thromboembolism. Similar previously reported cases show a large variation in the ECMO duration; however, the venoarterial mode of ECMO was commonly used in cases involving this complication. Although spinal infarction is rarely reported to occur in clinical practice after ECMO complications, it requires a high index of suspicion for recognition. Close monitoring of coagulation and platelet count and electrophysiological recording during ECMO may be useful in early detection and prevention of complications.http://www.sciencedirect.com/science/article/pii/S2214751920305892Artery of AdamkiewiczHypotensionInfluenzaParaplegiaSpinal cord |
| spellingShingle | Shih-Chao Chien Li-Kuo Kuo Shih-Chun Chien Yu-Jang Su Extracorporeal membrane oxygenation-related spinal cord infarction: A case report Interdisciplinary Neurosurgery Artery of Adamkiewicz Hypotension Influenza Paraplegia Spinal cord |
| title | Extracorporeal membrane oxygenation-related spinal cord infarction: A case report |
| title_full | Extracorporeal membrane oxygenation-related spinal cord infarction: A case report |
| title_fullStr | Extracorporeal membrane oxygenation-related spinal cord infarction: A case report |
| title_full_unstemmed | Extracorporeal membrane oxygenation-related spinal cord infarction: A case report |
| title_short | Extracorporeal membrane oxygenation-related spinal cord infarction: A case report |
| title_sort | extracorporeal membrane oxygenation related spinal cord infarction a case report |
| topic | Artery of Adamkiewicz Hypotension Influenza Paraplegia Spinal cord |
| url | http://www.sciencedirect.com/science/article/pii/S2214751920305892 |
| work_keys_str_mv | AT shihchaochien extracorporealmembraneoxygenationrelatedspinalcordinfarctionacasereport AT likuokuo extracorporealmembraneoxygenationrelatedspinalcordinfarctionacasereport AT shihchunchien extracorporealmembraneoxygenationrelatedspinalcordinfarctionacasereport AT yujangsu extracorporealmembraneoxygenationrelatedspinalcordinfarctionacasereport |