A major complication of ECMO patients?

• A. Myocardial infarction
• B. Pulmonary edema
• C. Deep vein thrombosis
• D. Intracranial bleeding

Answer: (D)

Bleeding risk from anticoagulation used to keep the ECMO circuit open is a defining danger. ECMO patients must be anticoagulated to prevent clots in the circuit, but that same anticoagulation can lead to bleeding in critical areas like the brain. Intracranial hemorrhage is particularly concerning because even small bleeds can expand quickly and cause irreversible brain injury or death, making it a major, high-stakes complication in ECMO care. Other issues like myocardial injury, pulmonary edema, or deep vein thrombosis can occur, but the brain bleed stands out for its severity and direct link to the anticoagulation and critical nature of cerebral bleeding.