Fracture of dual lumen cannula leading to cerebrovascular accident in a patient supported with ECMO.

Extended duration extracorporeal membrane oxygenation (ECMO), using dual-lumen cannulas, is being used with increased frequency to support patients, including those with COVID-19; both as a bridge to transplant and lung recovery. During such an extended duration of support, there are several factors that might lead to the attrition of the physical structure of the ECMO cannulas, predisposing them to the risk of fracture. Although rare, fracture of the ECMO cannula can be a potentially lethal event. Here, we present a case where fracture of a dual lumen cannula during veno-venous (VV) ECMO support resulted in a cerebrovascular accident. We discuss the potential contributing factors and suggest steps to mitigate the risks for such a complication.

使用双腔插管的长时间体外膜肺氧合（ECMO）越来越多地用于支持包括新冠肺炎患者在内的各类患者，既作为移植和肺恢复的过渡手段。在如此长时间的支持过程中，有若干因素可能导致ECMO插管的物理结构损耗，使其有断裂的风险。尽管罕见，但ECMO插管断裂可能是潜在的致命事件。在此，我们介绍一例在静脉 - 静脉（VV）ECMO支持期间双腔插管断裂导致脑血管意外的病例。我们讨论了潜在的促成因素，并提出了降低此类并发症风险的措施。