The Novel Application of Surgiflo and Successful Hemostasis of Refractory Intrapulmonary Hemorrhage in Extracorporeal Membrane Oxygenation.

Background: Intrapulmonary hemorrhage (IPH) is a life-threatening condition associated with specific risk factors including prolonged mechanical ventilation, therapeutic anticoagulation, and notably, mechanical circulatory support (MCS). MCS creates a constellation of conditions that predispose patients to IPH. Given the need for systemic anticoagulation and concomitant critical illness, managing IPH can be challenging. Consequently, extracorporeal membrane oxygenation (ECMO) is accompanied by an increased mortality rate.

Case summary: We present a case of a patient on ECMO complicated by severe intrapulmonary bleeding refractory to conventional therapies, but responded to the novel application of Surgiflo (a hemostatic matrix) to achieve hemostasis.

Conclusions: Endobronchial application of Surgiflo provides a viable option to manage refractory IPH.