Which of the following mechanical complications was reported as the most common in neonatal ECMO circuits?

In neonatal ECMO circuits, the most frequently encountered mechanical complication is the formation of clots in the blood path. This issue arises primarily due to the unique characteristics of neonatal patients, such as their smaller blood volume and varying coagulation factors. As the blood flows through the circuit, it encounters various surfaces that can activate the coagulation cascade, leading to thrombus formation.

Clots in the blood path can result in serious complications, including circuit obstruction, reduced oxygenation, and increased pressure within the circuit. Managing anticoagulation in neonates is particularly challenging, and achieving the right balance is crucial for minimizing clot formation while preventing bleeding complications. The propensity for clot formation in this population makes it imperative for perfusionists to monitor circuit function closely and to be prepared for interventions if clots are detected.

Understanding this complication is vital for clinicians working with ECMO, especially in vulnerable populations like neonates, where the consequences of circuit issues can significantly impact patient outcomes.