Jessica was admitted to the PICU at 2255 hours, accompanied by two anaesthetists, two perfusionists, an OR nurse and Odim. She was extremely pale and her extremities were cool. She had severe fluid retention-her body had retained an additional 1,280 millilitres of fluid while on bypass. Her urine had blood in it, and there was continuous bloody oozing from her sternum, which was a sign of a coagulopathy or clotting disorder.
Coagulopathy problems can arise when a patient has been on bypass for a long time.
Blood cells react differently when pushed through a bypass machine, as opposed to when they are normally pumped by the heart through the lungs. Thus, a lengthy bypass can damage the patient's blood cells and limit their ability to clot. For this reason, a wound that would normally clot quickly can turn into a serious site of bleeding following a prolonged period on bypass. Because ECMO is a type of bypass machine, it can also interfere with blood clotting. On Friday, Jessica was still on ECMO, which was being operated by a perfusionist.