A Dual-Lumen Bicaval Cannula for Venovenous Extracorporeal Membrane Oxygenation.


Journal

The Annals of thoracic surgery
ISSN: 1552-6259
Titre abrégé: Ann Thorac Surg
Pays: Netherlands
ID NLM: 15030100R

Informations de publication

Date de publication:
04 2020
Historique:
received: 08 06 2019
revised: 12 09 2019
accepted: 21 10 2019
pubmed: 22 12 2019
medline: 29 5 2020
entrez: 22 12 2019
Statut: ppublish

Résumé

Single-site, dual-lumen venovenous extracorporeal membrane oxygenation ECMO) facilitates mobilization, reduces recirculation, and mitigates insertion and infectious risks of an additional access site. This study reports the experience with a bicaval dual-lumen cannula that comprises a robust physical design allowing for easy and safe cannulation, precise positioning and monitoring, and appropriate physiologic support for patients with acute respiratory failure. Statistical analysis was performed from data gathered retrospectively from the electronic medical records of 20 adult patients who were cannulated for ECMO with this bicaval dual-lumen cannula from August 2018 through May 2019. Gas exchange and blood flow were optimized in all patients after cannulation (median pH, 7.42 [interquartile range {IQR}, 7.39, 7.44], ratio of arterial partial pressure of oxygen to fraction of inspired oxygen, 186.5 [Pao The bicaval dual-lumen cannula maintains the advantages of upper body single-site configuration to provide the adjunctive respiratory support necessary to facilitate awakening and rehabilitation while minimizing the use of invasive mechanical ventilation. This cannula introduces design qualities that may offer advantages for acute respiratory failure requiring venovenous ECMO.

Sections du résumé

BACKGROUND
Single-site, dual-lumen venovenous extracorporeal membrane oxygenation ECMO) facilitates mobilization, reduces recirculation, and mitigates insertion and infectious risks of an additional access site. This study reports the experience with a bicaval dual-lumen cannula that comprises a robust physical design allowing for easy and safe cannulation, precise positioning and monitoring, and appropriate physiologic support for patients with acute respiratory failure.
METHODS
Statistical analysis was performed from data gathered retrospectively from the electronic medical records of 20 adult patients who were cannulated for ECMO with this bicaval dual-lumen cannula from August 2018 through May 2019.
RESULTS
Gas exchange and blood flow were optimized in all patients after cannulation (median pH, 7.42 [interquartile range {IQR}, 7.39, 7.44], ratio of arterial partial pressure of oxygen to fraction of inspired oxygen, 186.5 [Pao
CONCLUSIONS
The bicaval dual-lumen cannula maintains the advantages of upper body single-site configuration to provide the adjunctive respiratory support necessary to facilitate awakening and rehabilitation while minimizing the use of invasive mechanical ventilation. This cannula introduces design qualities that may offer advantages for acute respiratory failure requiring venovenous ECMO.

Identifiants

pubmed: 31863760
pii: S0003-4975(19)31885-5
doi: 10.1016/j.athoracsur.2019.10.069
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1047-1053

Informations de copyright

Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Auteurs

Yuliya Tipograf (Y)

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Surgery, Columbia University Medical Center, New York, New York.

Whitney D Gannon (WD)

Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Pulmonary and Critical Care Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.

Neal M Foley (NM)

Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Ahmed Hozain (A)

Department of Biomedical Engineering, Columbia University Medical Center, New York, New York.

Rei Ukita (R)

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Matthew Warhoover (M)

Department of Perfusion, Vanderbilt University Medical Center, Nashville, Tennessee.

William McMaster (W)

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Jonathan C Nesbitt (JC)

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Ashish S Shah (AS)

Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Matthew Bacchetta (M)

Department of Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Cardiac Surgery, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Biomedical Engineering, Columbia University Medical Center, New York, New York. Electronic address: matthew.bacchetta@vumc.org.

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