Peripheral neuropathy after extra-corporeal membrane oxygenation therapy in children

Abstract

Rationale:In recent years, the use of extracorporeal membrane oxygenation (ECMO) treatment for pediatric patients with cardiorespiratory failure has increased, with emphasis being given to the prevention of complications in ECMO-treated patients. Several studies have reported ECMO-related central nervous system complications, such as intracranial hemorrhage, cerebral infarction, and seizure. However, few cases of peripheral nerve injury have been reported in ECMO-treated adults; there have also been no reported cases of peripheral nerve injury in the pediatric population.Patient Concerns:Two pediatric patients aged 16 and 6 experienced motor weakness in the extremities after the insertion of ECMO equipment.Diagnoses:They were diagnosed with peripheral nerve injuries through an electrodiagnostic study that showed femoral/sciatic neuropathies and brachial plexopathy. Arteriography and doppler sonography was performed to find the cause of peripheral nerve injury, and this may be the results of vascular compromise and compressive injuries, respectively.Interventions:Surgical embolectomy was performed to remove thrombus in one patient. Two patients received orthosis, and physical therapy and occupational therapy were performed to prevent contracture and improve strength and functional use.Outcomes:Two pediatric patients showed a gradual improvement in motor power and function.Lessons:Through this case report, we present rare ECMO-related complications and emphasize the importance of early diagnosis and monitoring of peripheral nerve injury in ECMO-treated children.

Neurological improvement following revision of vascular graft remnants in the upper extremity

“…Direct injury to a nerve may occur owing to needle puncture or manual pressure. 3 , 4 , 5 , 6 In other cases, neurological deficit may result from compression owing to the presence of a mass, such as a hematoma, pseudoaneurysm, or vascular graft. 7 In such cases, nerve decompression with or without removal of the offending mass can yield clinical improvement.…”