case_images: PMC6358340_01
case_images: Chest X-rays in a critically ill neonate with PHMD receiving ECMO and CRRT therapy. Notes: (A) Before ECMO therapy; (B) Seven hours after initiation of ECMO; (C) Decannulation of ECMO. CRRT = continuous renal replacement therapy, ECMO = extracorporeal membrane oxygenation, PHMD = pulmonary hyaline membrane disease.
case_images: medi-98-e14194-g001.jpg
case_images: PMC6358340_01_medi-98-e14194-g001.jpg
case_images: F1
case_images: Main changes of chest X-ray were reduction of lung transparency and frosted glass-like changes of the lung fields, which were in accordance with the diagnosis of HMD (Fig. 1A). Repeated chest X-ray confirmed the appropriate position of cannulas of ECMO circuit, also revealed diffuse exudation of both lung fields which was the so-called "white-out", and exacerbation of fluid overload was obvious (Fig. 1B). Repeated chest film revealed significant improvement regarding to fluid overload (Fig. 1C).
case_images: Description of incorporating a CRRT device to ECMO circuit. Notes: (A) Initiation of ECMO; (B) Inclusion of a CRRT device to ECMO circuit; (C) Schematic diagram of incorporating a CRRT device to the ECMO circuit; (D) Discontinuation of mechanical support (29 days post-ECMO). CRRT = continuous renal replacement therapy, ECMO = extracorporeal membrane oxygenation.
case_images: medi-98-e14194-g002.jpg
case_images: PMC6358340_01_medi-98-e14194-g002.jpg
case_images: F2
case_images: AG, Stolberg, Germany) was commenced (Fig. 2A), allowing the heart and lung to rest. An 8-Fr arterial cannula was inserted into the right common carotid artery, while the right internal jugular vein was cannulated by a 12-Fr venous cannula. Immediate after the initiation of ECLS, CRRT circuit was connected the post-oxygenator and returned pre-oxygenator of ECMO (Fig. 2B and C). After sepsis and respiratory disorder were properly managed, the neonate was extubated and weaned from mechanical support 29 days after ECLS (Fig. 2D).