Total retinal detachment in a preterm infant treated with ECMO. Extracorporeal membrane oxygenation.

Introduction

Extracorporeal membrane oxygenation (ECMO) can provide respiratory and cardiac support for critically ill patients and has been used successfully in the management of a variety of neonatal diseases.¹ In neonatal venoarterial ECMO, mixed venous blood is usually drained from the right atrium, pumped through the oxygenator (to add oxygen and remove carbon dioxide), rewarmed, and returned to the aortic arch.¹

Due to membrane oxygenator efficiency, the PaO₂ of blood returning to the aorta may be greater than 100 mm Hg, even when only unsupplemented air is swept through the oxygenator for gas exchange. Most neonates treated with ECMO have been full-term or nearly full-term, but the technique is occasionally used for preterm infants.²

To date, there is no indication that retinopathy of prematurity (ROP) or retinal vessel abnormalities occur in newborns treated with ECMO. We, therefore, report this case of a preterm patient who developed retinopathy after venoarterial ECMO. The etiologic relationship between the use of ECMO per se and neovascular retinopathy is not certain. Nevertheless, physicians involved in the care of preterm infants should be aware of a possible association.