That's probably the last thing one wants to hear after answering a page!
Fortunately, the kiddo is doing better and did not require a second ECMO run (near diaphragmatic agenesis). This prompted a search for some literature on the subject of second run ECMO. Took a bit of research but found an article by Meehan et al. that looked at 205 patients from the ELSO neonatal registry who underwent multiple ECMO runs.
My main concern whenever the subject of potential need for recannulation comes up is the issue of recannulating the right CCA and CJV (A scenario encountered in 56% of patients in this study), with the potential for embolic events.
In their review, the authors noted a 20% increase in complication rates, with the largest increase in complication rates being for neurologic (134% increase) and infectious complications (79% increase). The most common type of neurologic complications were clinical seizures and radiologically documented cerebral strokes.
Overall survival after a second run was 38% (32% for CDH).
Journal of Pediatric Surgery, Vol 37, No 6 (June), 2002:pp 845-850
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