Differential diagnosis of complications of pediatric extracorporeal membrane oxygenation

• Contraindications to ECMO
• Catheter malposition
• Hemothorax
• Intraabdominal hemorrhage
• Intramuscular hematoma
• Subdural hematoma
• Intracerebral hemorrhage
• Intraventricular non-neonatal hemorrhage
• Cerebellar hemorrhage
• Cerebral atrophy post ECMO

Approach to the differential diagnosis of complications of extracorporeal membrane oxygenation (ECMO)

• Obtain neuroimaging pre-ECMO to exclude contraindications to ECMO such as pre-existing intracranial bleed or brain malformation
• Check ECMO catheters closely for malposition
• Obtain regular surveillance neuroimaging with head ultrasound to check for intracranial bleeding
• If there is concern for bleeding in the chest, abdomen, or muscles investigate with US
• Document the baseline cerebral atrophy present post-ECMO