• Perfusion · Jul 2015

    Veno-arterial extracorporeal membrane oxygenation support for severe cardiac failure in a pediatric patient with intracranial hemorrhage after spontaneous aneurysmatic rupture.

    • Robert Zant, Michael Melter, Christian Doerfler, Stephan Gerling, Leopold Rupprecht, Alois Philipp, and Juergen Kunkel.
    • KUNO University Children's Hospital Regensburg, Germany robert.zant@ukr.de.
    • Perfusion. 2015 Jul 23.

    IntroductionExtracorporeal life support in adult patients with extended intracranial hemorrhage is controversial. In pediatric patients, it has traditionally been considered a contraindication as systemic anticoagulation may worsen the hemorrhage and neurological outcome.Case HistoryWe present a nine-year-old female patient who was admitted with extended intracranial hemorrhage after spontaneous rupture of an aneurysm. On day four after the emergency craniotomy, she required veno-arterial extracorporeal membrane oxygenation for septic shock. Using an adapted anticoagulation protocol aimed at lower activated partial thromboplastin time target values, we did not observe any new bleeding or clotting complications during systemic anticoagulation and the patient had good neurological recovery.ConclusionExtracorporeal life support with low dose systemic anticoagulation can be considered as a treatment option in pediatric patients after craniotomy for intracranial aneurysmatic hemorrhage.© The Author(s) 2015.

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