Abstract
Background: Flexible bronchoscopy (FB) is a well-established tool for the diagnosis and treatment of pulmonary disorders in children. For children receiving Extracorporeal Membrane Oxygenation (ECMO) and systemic anticoagulation, bleeding has been reported as an adverse event following FB. Therefore, we sought describe the safety profile of FB during ECMO.
Methods: An IRB approved retrospective review was conducted on subjects who received FB while on ECMO between 2015-2018. Demographic, clinical findings, laboratory, mechanical ventilation, anticoagulation profiles, ECMO and mechanical ventilation data were evaluated prior to and following FB. Descriptive statistics and Wilcoxon matched-pairs signed rank test were used for pre and post intervention comparisons. Data are presented as median and interquartile range.
Results: 18 Subjects (male=7); weight 13.67 kg (2.5-77 kg) underwent FB on ECMO (4 veno-venous) and (14 veno-arterial). ECMO duration was 22 days (2-42 days) and FB was performed 12 (0.29-30.37 days) from the initiation of ECMO support. Indications for FB included 56% therapeutic and 44% diagnostic. Four subjects (22%) required a red blood cell transfusion for hematocrit <30% within 6-hours of FB. No statistically significant differences were observed for included variables pre and post FB (Table 1.) and no additional adverse events were reported.
Conclusions: In our limited cohort, FB was not associated with major bleeding, titration of heparin dose, adjustment of mechanical ventilation and ECMO support. These data suggest that FB is a safe bedside procedure during ECMO support of critically ill children that may yield both therapeutic and diagnostic benefits.
Footnotes
Commercial Relationships: None
- Copyright © 2020 by Daedalus Enterprises
In this issue
