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Peripheral neuropathy after extracorporeal membrane oxygenation therapy in children

Extracorporeal membrane oxygenation (ECMO) has made significant progress in recent years and is now a viable treatment option for adults and children suffering from cardiorespiratory failure.

Extracorporeal membrane oxygenation (ECMO) has made significant progress in recent years and is now a viable treatment option for adults and children suffering from cardiorespiratory failure. After ECMO, neurologic problems are common, with the frequency and types of neurologic issues changing by patient demographic. Neurological problems have been documented in 7.1 percent of ECMO-treated adults, according to data from the National Extracorporeal Life Support Organization (ELSO) Registry, with intracranial bleeding being the most prevalent, followed by an acute ischemic stroke in adults. Children with cardiorespiratory failure have a greater survival rate than adults, and peripheral nerve injury can have a substantial impact on the quality of life of ECMO survivors. Two pediatric cases of ECMO-related peripheral nerve damage are described in this article.


After ingesting herbal medicine containing Aconiti ciliare tuber extract, a 16-year-old kid with no vascular disease or other comorbidities was admitted to the hospital. As a result of diminished cardiac function with an ejection fraction (EF) of 10% on portable transthoracic echocardiography on hospital day (HD) 1, venoarterial extracorporeal membrane oxygenation (VA-ECMO) was inserted with the right inferior vena cava and common femoral artery. The aberrant spontaneous activity in the right TA, peroneus longus, medial gastrocnemius, and semimembranosus muscles were disappeared, while massive and polyphasic motor unit action potentials in the right vastus lateralis remained. This finding matched chronic femoral and sciatic neuropathies with re-innervation signals, indicating a favorable prognosis. In addition, the patient's muscle strength improved, and the ankle-foot orthosis was no longer required.
 

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Mohammed
Fri, 11/26/2021 - 21:36 Permalink

Ko JY, Lee MR, Ha EH, Kim A. Peripheral neuropathy after extra-corporeal membrane oxygenation therapy in children: A case report. Medicine (Baltimore). 2021 Nov 12;100(45):e27735. doi: 10.1097/MD.0000000000027735. PMID: 34766582.

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