Cannulation and decannulation techniques for neonatal ECMO

Jensen, Amanda R.; Davis, C.L.; Gray, Brian W.

doi:10.1016/j.siny.2022.101404

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…The Crescent® pediatric cannula is available in sizes of 13, 15, and 19 Fr, has received FDA clearance, and is currently awaiting CE marking. 10 The adult BC Crescent® cannula (Medtronic) has gained significant attention since its introduction to the market. Clinical reports indicate that the standard insertion site of the right internal jugular vein can be expanded to include the subclavian vein and left internal jugular vein, making the cannula placement more feasible and versatile.…”

Section: Dual Lumen Cannulasmentioning

confidence: 99%

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Year in review: Highlights in ECLS Innovation and Technology, Anno 2022-2023

Vercaemst

2023

Perfusion

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Background In the field of extracorporeal life support (ECLS), the rapid influx of novel technologies and innovative techniques presents an ongoing challenge for professionals to stay informed about these advancements. To address this issue and ensure the ECLS community remains up-to-date, we have compiled a concise overview of recent technological innovations in ECLS. Purpose This overview focuses primarily on academically investigated and reported advancements in the ECLS domain. It underscores the importance of transparent communication regarding technological limitations in healthcare and advocates for collaboration between medical professionals and engineers to elevate patient care. Research Design This manuscript presents a compilation of recent technological advancements in ECLS, with an emphasis on innovations that have been academically explored and documented. The research approach involves gathering information from scholarly sources, reports, and studies to provide a comprehensive overview. Study Sample The study sample comprises a diverse range of recent technological innovations in the field of extracorporeal life support (ECLS). These innovations span various aspects of ECLS technology and have been investigated and reported on within the academic literature. Analysis Data collection involved systematically reviewing academic literature, reports, and studies related to recent technological advancements in ECLS. The collected information was then analyzed to identify common trends, notable developments, and the impact of these innovations on patient care. Results The compilation highlights several significant technological innovations within the ECLS domain. Notable advancements include the development of new dual lumen cannulae, innovative devices for left ventricular (LV) unloading, lightweight ECMO transport systems, streamlined driving consoles to facilitate patient mobility, intricate systems for extracorporeal cardiopulmonary resuscitation (ECPR), standardized driving consoles for networking, and non-invasive circuit pressure monitoring. Some of these innovations have obtained regulatory approvals for distribution in the United States and/or authorization for the European market. Conclusions The manuscript underscores the critical role of collaboration between clinicians, researchers, and industry in driving recent technological innovations within the ECLS field. It emphasizes the necessity of open communication about technological limitations and the potential for repurposing established technologies in novel ways. However, the resourcefulness of physicians in repurposing devices requires validation through comprehensive scientific and technical investigation. Thus, fostering broader collaboration among stakeholders is recommended to ensure the rigorous evaluation and validation of new applications for established ECLS devices.

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Section: Dual Lumen Cannulasmentioning

confidence: 99%

“…The Crescent® pediatric cannula is available in sizes of 13, 15, and 19 Fr, has received FDA clearance, and is currently awaiting CE marking. 10…”

Section: Dual Lumen Cannulasmentioning

confidence: 99%

Year in review: Highlights in ECLS Innovation and Technology, Anno 2022-2023

Vercaemst

2023

Perfusion

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“…Neonatal ECMO cannulation remains a challenging procedure, due to delicate vessels and critical condition. Although there have been many reports of surgical technique for neck V-A ECMO cannulation and decannulation in neonates (3)(4)(5), there is still no consensus on the carotid artery ligation or repair during decannulation. Our hospital is a tertiary referral center in Mainland China and started neonatal and children ECMO from 2008.…”

Section: Introductionmentioning

confidence: 99%

Veno-arterial extracorporeal membrane oxygenation for respiratory and cardiac support in neonates: a single center experience

Wang,

Li,

Zhou

et al. 2024

Front. Cardiovasc. Med.

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ObjectiveExtracorporeal membrane oxygenation (ECMO) is an advanced life support that has been utilized in the neonate for refractory respiratory and circulatory failure. Striving for the best outcomes and understanding optimal surgical techniques continue to be at the forefront of discussion and research. This study presents a single-center experience of cervically cannulated neonatal patients on V-A ECMO, a description of our cannulation/decannulation techniques and our patient outcomes.MethodsSingle center retrospective review of neonates who received neck V-A ECMO support from January 2012 to December 2022. The data and outcomes of the patients were retrospectively analyzed.ResultsA total of 78 neonates received V-A ECMO support. There were 66 patients that received ECMO for respiratory support, the other 12 patients that received ECMO for cardiac support. The median duration of ECMO support was 109 (32–293) hours for all patients. During ECMO support, 20 patients died and 5 patients discontinued treatment due to poor outcome or the cost. A total of 53 (68%) patients were successfully weaned from ECMO, but 3 of them died in the subsequent treatment. Overall 50 (64%) patients survived to hospital discharge. In this study, 48 patients were cannulated using the vessel sparing technique, the other 30 patients were cannulated using the ligation technique. We found no significant difference in the rates of normal cranial MRI at discharge between survivors with and without common carotid artery ligation.ConclusionWe achieved satisfactory outcomes of neonatal ECMO in 11-year experience. This study found no significant difference in early neuroimaging between survivors with and without common carotid artery ligation. The long-term neurological function of ECMO survivors warranted further follow-up and study.

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