Vascular site hemostasis in percutaneous extracorporeal membrane oxygenation therapy

Bleeding is a well described complication of percutaneous extracorporeal membrane oxygenation support (ECMO). In an effort to prevent ongoing percutaneous-cannula blood loss, we tried multiple methods to achieve hemostasis and obtained the best results with QuikClot Combat Gauze (Z-Medica Corp, Wallingford, CT). This product is made of kaolin, white alumina silicate clay, which initiates activation of the intrinsic clotting cascade. We reviewed our experience in 21 ECMO patients and found 5 patients who required 17 applications of QuikClot Combat Gauze to percutaneous catheter insertion sites and demonstrated a significant reduction in both localized bleeding complications and the need for blood transfusion. QuikClot Combat Gauze, used for the dual purpose of a dressing and hemostatic agent, is a simple valuable method to control pericatheter bleeding in the ECMO population with demonstrated cost savings and clinical utility.