• Hayato Taniguchi, Tokuji Ikeda, Ichiro Takeuchi, and Shingo Ichiba.
• Hayato Taniguchi is an assistant professor, Department of Surgical Intensive Care Medicine, Nippon Medical School Hospital, Tokyo, Japan, and Advanced Critical Care and Emergency Center, Yokohama City University Medical Center, Yokohama, Japan.
• Am. J. Crit. Care. 2021 Jan 1; 30 (1): 55-63.

BackgroundIliopsoas hematoma occasionally occurs in patients receiving anticoagulation therapy. It may be a life-threatening complication and can cause disseminated intravascular coagulation, which could develop into abdominal compartment syndrome. The incidence of and factors associated with iliopsoas hematoma during venovenous extracorporeal membrane oxygenation (ECMO) have not been well studied.ObjectivesTo describe the incidence of iliopsoas hematoma and associated factors among patients undergoing venovenous ECMO.MethodsA retrospective cohort study was conducted at Nippon Medical School Hospital from April 2015 to October 2018. All patients (>18 years old) with iliopsoas hematoma received a diagnosis based on computed tomography.ResultsDuring the study period, 54 patients were supported with venovenous ECMO. Iliopsoas hematoma occurred in 8 of those patients (15%), none of whom had disseminated intravascular coagulopathy or abdominal compartment syndrome develop. Univariate analysis indicated that management of ECMO while the patient was awake and mobilization beyond sitting on the edge of the bed were significantly different (P < .05) in patients with and patients without iliopsoas hematoma. Mortality, however, did not differ significantly between the 2 groups.ConclusionsOur findings emphasize that recognizing factors associated with iliopsoas hematoma and detecting them early are crucial during venovenous ECMO in order to treat patients with iliopsoas hematoma appropriately.©2021 American Association of Critical-Care Nurses.

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