[Recurrent arterial thrombosis during extracorporeal membrane oxygenation: a case report and literature review].

Abstract

Extracorporeal membrane oxygenation (ECMO) is an advanced technology that provides short-term life support for patients with severe cardiopulmonary failure based on the principle of cardiopulmonary bypass. However, various complications such as acute limb ischemia, osteofascial compartment syndrome, hemorrhage and thrombosis can also occur. A retrospective analysis was performed on a 58-year-old Han male patient with acute myocardial infarction complicated with cardiogenic shock in our department. After the conventional treatment failed, he received urgent VA-ECMO treatment. During this period, arterial thrombosis occurred repeatedly, improved after anticoagulant and antithrombotic treatment, and finally died due to infection. Acute limb ischemia caused by arteriovenous thrombosis is one of the possible serious complications during ECMO treatment. Prevention of thrombosis and optimization of anticoagulant and antithrombotic regimen are the main therapeutic measures. Anticoagulation is still the main treatment method for venous thrombosis during ECMO treatment. Anti-thrombotic drugs are not routinely given during ECMO, while anti-thrombotic drugs are the primary treatment for high-risk arterial thrombosis risk patients. Therefore, early detection of complications and timely intervention are crucial. Early intervention or surgical operation can reduce the incidence of ischemia,improve the survival rate and reduce the disabling outcome.