Weaning from neonatal and pediatric ECMO with stand-by cannula

Pérez, Sandra Martínez; Cuaresma, Adriana; Girona‐Alarcón, Mònica; Solé‐Ribalta, Anna; Cañizo, Débora; Cambra, Francisco José; Jordán, Iolanda; Segura, Susana; Pertierra, Africa

doi:10.1007/s10047-021-01251-x

Cited by 2 publications

(2 citation statements)

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“…In 31 patients, the ECMO cannula was removed with a delay of 0.9–7.2 days after ending ECMO support. This approach has recently described to be feasible in neonatal and pediatric patients receiving VA ECMO 21–23 . Based on our data, delaying ECMO cannula removal following VV ECMO support seams safe.…”

Section: Discussionmentioning

confidence: 60%

“…This approach has recently described to be feasible in neonatal and pediatric patients receiving VA ECMO. [21][22][23] Based on our data, delaying ECMO cannula removal following VV ECMO support seams safe. Although PH and cardiac dysfunction improve during VV ECMO in most patients, 24,25 CDH neonates are at increased risk of aggravation of pre-existing pulmonary hypertension and cardiac dysfunction, especially following surgical repair.…”

Section: Discussionmentioning

confidence: 70%

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Percutaneous, ultrasound‐guided single‐ and multisite cannulation for veno‐venous extracorporeal membrane oxygenation in neonates

Kipfmueller

Schmitt

et al. 2023

Pediatric Pulmonology

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AimsExtracorporeal membrane oxygenation (ECMO) is a widely used technique to support neonates with severe respiratory failure. Data on percutaneous, ultrasound‐guided veno‐venous (VV) ECMO cannulation in neonates is still scarce. Aim of this study was to describe our institutional experience with ultrasound‐guided percutaneous, VV ECMO cannulation in neonates with severe respiratory failure.MethodsNeonates receiving ECMO support at our department between January 2017 and January 2021 were retrospectively identified. Patients receiving VV ECMO cannulation performed by the percutaneous Seldinger technique by single‐ or multisite cannulation were analyzed.ResultsA total of 54 neonates received ECMO cannulation performed by the percutaneous Seldinger technique. In 39 patients (72%) a 13 French bicaval dual‐lumen cannula was inserted and in 15 patients (28%) two single‐lumen cannulae were used. Cannulae positioning using the multisite approach was in all cases as desired. The tip of the 13 French cannula was located in the IVC in 35/39 patients, in four patients position was too proximal but did not dislocate during the ECMO run. One (2%) preterm neonate (weight 1.75 kg) developed a cardiac tamponade which was successfully managed with drainage. Median duration of ECMO was 7 days (interquartile range: 5–16 days). Forty‐four patients (82%) were successfully weaned from ECMO and in 31/44 (71%) the ECMO cannulae were removed with a delay of 0.9–7.2 days (median 2.8 days) after weaning without noticing complications.ConclusionsA correct cannula placement using the ultrasound‐guided percutaneous Seldinger technique, for both single‐ and multisite cannulation, seems feasible in most neonatal patients receiving VV ECMO.

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Section: Discussionmentioning

confidence: 60%