Iliopsoas haematoma: unexpected life-threatening complication during extracorporeal membrane oxygenation support in H1N1-induced acute respiratory distress syndrome patients

The use of extracorporeal membrane oxygenation (ECMO), as recently suggested by the results of CESAR trial,1 can improve the outcome in patients with acute respiratory distress syndrome (ARDS). ECMO has been adopted in H1N1-induced ARDS since last year.2 Although ECMO is a safe and feasible device if used in specialized centres,2 ECMO-related complications can occur in circuit insertion/management (cannulae, pump, filter) and due to heparin infusion (haemorrhages). We report on two patients admitted to the intensive care unit (ICU) of ECMO referral centre (Careggi Teaching Hospital, Florence, Italy) in January 2011, during the second season of H1N1 pandemic.