Extracorporeal membrane oxygenation therapy remains a life saving modality for neonates with cardiopulmonary disease that is unresponsive to conventional therapy. Vital to its success is the insertion and maintenance of appropriately sized vascular cannulas. Problematic insertion and accidental dislodgments can be life threatening. To determine the treatment and outcome of these complications, a survey of participating Extracorporeal Life Support Organization centers was undertaken. Venous cannulation complications (13 patients) were due to inadequate vein size or tearing during initial attempts at cannulation. Proximal and alternative site cannulation were used. Difficult arterial cannulations (seven patients) were most often due to creation of an intimal flap that was corrected by proximal cannulation of the same vessel. The 10 cases of accidental dislodgment were most often associated with changes in position. Despite copious hemorrhage in many instances, 6 of 10 patients survived with intact neurologic status. Methods for dealing with these life threatening cannula related complications are described.

Cardiovascular Diseases↗

PubMedDate not supplied

An unusual lateral neck cyst with the combined features of a bronchogenic, thyroglossal, and branchial cleft origin.

Soft tissue cystic masses arising in the neck in children are commonly of embryologic origin and often surgically excised. Depending on location and histology, they can be classified as thyroglossal duct, branchial cleft, or rarely bronchogenic in origin. We present an unusual case of an infant with a lateral neck mass that communicates with the midtrachea. The histologic appearance is that of a combination of the features seen in cysts of branchial cleft and thyroglossal duct origin. The possible embryologic development of such a lesion is discussed.

Branchioma↗