3.3 Bleeding
Complications in the ECMO support are important predictors of poor
outcomes. The most common complication was bleeding of this study.
Sixteen cases experienced severe surgical site bleeding requiring
explorations and 11 cases died. Neonates have small volume of
circulating blood and immature blood coagulation mechanism, ECMO
prefilling dilute the anticoagulant components and longer CPB time
destroyed blood components. Improving supplement coagulation components
and try to correct coagulation defects are very important[13]. There were four cases experienced severe GI
bleeding and only one survived, and two cases with ECPR time greater
than 30min before ECMO. GI bleeding resulted from infection, ischemia
and hypoxia, feeding and blood flow to premature labor when patients
under critical illness. Studies have shown that 90%-95% necrotizing
enterocolitis (NEC) occurs in premature and low birth weight infants
with a gestational age of less than 36weeks, which is the result of a
combination of risk factors [17]. The literature
believes that feeding factors (type, speed and concentration) are
intrinsically linked to the occurrence of NEC, because the neonatal
digestive system is immature and susceptible to ischemic injury; and
digestive enzyme activity is low, which will eventually increase the
incidence of NEC [18].