Published online Jul 6, 2021. doi: 10.12998/wjcc.v9.i19.5203
Peer-review started: January 27, 2021
First decision: February 11, 2021
Revised: February 21, 2021
Accepted: May 15, 2021
Article in press: May 15, 2021
Published online: July 6, 2021
Processing time: 147 Days and 16.9 Hours
Retroperitoneal hemorrhage (RPH) is a rare and severe complication in patients undergoing extracorporeal membrane oxygenation (ECMO). Clinical diagnosis is difficult.
Three cases of RPH patients with corona virus disease-19 (COVID-19) were included in this study. All three suffered from respiratory failure, were treated with veno-venous or veno-arterial-venous ECMO, and experienced RPH during ECMO treatment. Two of the COVID-19 cases were diagnosed after the patients experienced abdominal pain. The other patient exhibited decreases in the ECMO circuit flow rate and hemoglobin level. Two cases were treated by transcatheter arterial embolization, and one was treated conservatively. The hemorrhage in each of the three cases did not deteriorate. Satisfactory treatment results were achieved for the three patients because of prompt diagnosis and treatment.
Although the incidence of RPH during ECMO treatment is low, the risk is increased by anticoagulant use and local mechanical injury. If declines in blood flow velocity and hemoglobin are detected, RPH should be considered, and prompt aggressive therapy should be started.
Core Tip: Retroperitoneal hemorrhage (RPH) is a rare complication during the application of extracorporeal membrane oxygenation (ECMO). Corona virus disease-19 (COVID-19) is often accompanied by coagulation disorders, and the use of heparin in patients with severe COVID-19 patients during ECMO treatment increases the bleeding risk. Three COVID-19 patients who experienced RPH during ECMO treat