Peripheral veno-artertial extracorporeal membrane oxygenation (VA-ECMO) is commonly used in the paediatric population for intractable respiratory and cardiac failure. One of the devastating complications of VA-ECMO is severe brain damage due to ischemia or haemorrhage. We describe a case of peripheral cervical VA-ECMO complicated by evolving right cerebral ischemia which was rescued with rapid conversion from peripheral to central VA-ECMO support. Notably, the patient had a complete circle of Willis. Following conversion, we observed complete resolution of neurological symptoms with full functional recovery.
Hervey-JumperSLAnnichGMYanconAR, et al.Neurological complications of extracorporeal membrane oxygenation in children: clinical article. PED2011; 7: 338–344.
2.
TeeleSASalvinJWBarrettCS, et al.The association of carotid artery cannulation and neurologic injury in pediatric patients supported with venoarterial extracorporeal membrane oxygenation. Pediatric Critical Care Medicine2014; 15: 355–361.
3.
RollinsMDHubbardAZabrockiL, et al.Extracorporeal membrane oxygenation cannulation trends for pediatric respiratory failure and central nervous system injury. Journal of Pediatric Surgery2012; 47: 68–75.
4.
WerhoDKPasqualiSKYuS, et al.Epidemiology of stroke in pediatric cardiac surgical patients supported with extracorporeal membrane oxygenation. The Annals of Thoracic Surgery2015; 100: 1751–1757.
5.
PatukaleAPowellJMaratheS, et al.Cerebral infarction during cervical veno-arterial extracorporeal membrane oxygenation in children: can it be predicted?World J Pediatr Congenit Heart Surg2022: 215013512210855.
6.
SonobeAKatoHMathisBJ, et al.Catastrophic cerebral infarction during extracorporeal life support due to a rare anomaly in the circle of Willis. Interactive CardioVascular and Thoracic Surgery2019; 29: 816–817.
7.
MirozJ-PBen-HamoudaNBerniniA, et al.Neurological pupil index for early prognostication after venoarterial extracorporeal membrane oxygenation. Chest2020; 157: 1167–1174.
8.
SvrckovaPMeshakaRHoltrupM, et al.Imaging of cerebral complications of extracorporeal membrane oxygenation in infants with congenital heart disease — ultrasound with multimodality correlation. Pediatr Radiol2020; 50: 997–1009.
9.
SaidASGuilliamsKPBembeaMM. Neurological monitoring and complications of pediatric extracorporeal membrane oxygenation support. Pediatric Neurology2020; 108: 31–39.
