Subdural extravasation of crystalloids and blood products through a scalp peripheral intravenous catheter into the subdural space of a neonate on veno-arterial extracorporeal membrane oxygenation
Affiliations: [a] Department of Pediatrics, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| [b] Department of Surgery, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| [c] Department of Neurosurgery, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
| [d] Department of Radiology, Columbia University Irving Medical Center, New York Presbyterian Hospital, New York, NY, USA
Correspondence:
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Address for correspondence: Amélie Collins, Department of Pediatrics, 622 West 168th Street PH-17, New York, NY 10032, USA. Tel.: +1 212 305 8500; Fax: +1 212 305 8796; E-mail: ac3310@cumc.columbia.edu.
Abstract: We describe a rare and devastating complication of a malpositioned scalp peripheral intravenous catheter (PIV) that resulted in subdural extravasation of infused fluids and midline shift in a critically ill neonate who required extracorporeal membrane oxygenation (ECMO). Recognition of increased intracranial pressure was hindered by the hemodynamic changes of being on ECMO and only identified by routine surveillance ultrasonography. Awareness of this complication may lead providers to seek alternate sites for vascular access in such patients, and encourage closer monitoring for this complication when an alternate site is unavailable.
