Carotid Artery Dissection Following Neck Cannulation for Extracorporeal Life Support

Ryerson, Lindsay; Sanchez-Glanville, Carlos; Huberdeau, Christa; Aklabi, Mohammed Al

doi:10.1177/2150135116639542

Cited by 7 publications

(11 citation statements)

References 9 publications

(15 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our report of complications follows the classification of Fletcher-Sandersjöö et al , 1 and hence includes many interventions that took place as part of ECLS initiation and that have not been considered as complications in other reports. 1,20,21,24,25,30…”

Section: Discussionmentioning

confidence: 99%

“…13 Also, there are no standard definitions for ECLS transport-related complications and/or adverse events, with high variability in their reporting. 1,14,15,[19][20][21][22][23][24][25][26][27] Pediatric ECLS transport complications have been poorly described in previous reports. Although our rate of complications was higher than reported by other centers (95.5% vs 28-65%), there were no transport deaths and survival to hospital discharge was comparable to Stollery ECLS survival and higher than the ELSO pediatric survival to hospital discharge of 61%.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Extracorporeal Life Support Transport in Western Canada: Experience over 14 years

Leung¹,

Guerra

DeCaen

et al. 2021

ASAIO Journal

View full text Add to dashboard Cite

This retrospective cohort study describes all children transported on extracorporeal life support (ECLS) by the Stollery Children's Hospital Pediatric Transport team (SCH-PTT) between 2004 and 2018. We compared outcomes and complications between primary (SCH-PTT performed ECLS cannulation) vs. secondary (cannulation performed by referring facility) transports, as well as secondary transports from referring centers with and without an established ECLS cannulation program. SCH-PTT performed 68 ECLS transports during the study period. Median (IQR) transport distance was 298 (298-1,068) kilometers. Mean (SD) times from referral call to ECLS-initiation were: primary transports 7.8 (2.9) vs. 2.5(3.5) hours for secondary transports, p value < 0.001. Complications were common (n = 65, 95%) but solved without leading to adverse outcomes. There were no significant differences in the number of complications between primary and secondary transports. There was no significant difference in survival to ECLS decannulation between primary 9 (90%) and secondary transports 43 (74%), p value = 0.275. ECLS survival was higher for children cannulated by the SCH-PTT or a center with an ECLS cannulation program: 42 (82%) vs. 10 (59%), p value = 0.048. Critically ill children on ECLS can be safely transported by a specialized pediatric ECLS transport team. Secondary transports from a center with an ECLS cannulation program are also safe and have similar results as primary transports.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Pediatric Extracorporeal Life Support Transport in Western Canada: Experience over 14 years

Leung¹,

Guerra

DeCaen

et al. 2021

ASAIO Journal

View full text Add to dashboard Cite

show abstract

“…Other problems reported with this type of peripheral cannulation approach are dissection of the aorta or carotid artery (36). Early recognition and timely intervention to those complications are critical, and serial Echocardiograms should be provided to detect problems.…”

Section: Peripheral Vs Central Cannulationmentioning

confidence: 99%

“…Decannulation for neonatal cardiac ECMO is done surgically and can be performed either in the ICU or in the operating room. Neck cannulation often leads to vessel reconstruction and the cannulation sites must be investigated carefully for any damage, which might need extended repair, such as carotid artery dissection (36). Furthermore, Di Gennaro et al published a study showing increased risk of stroke in patients with carotid cannulation (79).…”

Section: Weaningmentioning

confidence: 99%

Neonatal Cardiac ECMO in 2019 and Beyond

Roeleveld

Mendonca

2019

Front. Pediatr.

View full text Add to dashboard Cite

Worldwide, the use of Extracorporeal Membrane Oxygenation (ECMO) for cardiac failure has been steadily increasing in the neonatal population and has become a widely accepted modality. Especially in centers caring for children with (congenital) heart disease, ECMO is now an essential part of care available for those with severe heart failure as a bridge to recovery, long term mechanical support, or transplantation. Short-term outcomes depend very much on indication. Hospital survival is ~40% for all neonatal cardiac ECMO patients combined. ECMO is being used for pre- and/or post-operative stabilization in neonates with congenital heart disease and in neonates with medical heart disease such as myocarditis, cardiomyopathy or refractory arrhythmias. ECMO use during resuscitation (ECPR) or for sepsis is summarized elsewhere in this special edition of Frontiers in Pediatrics. In this review article, we will discuss the indications for neonatal cardiac ECMO, the difficult process of patients' selection and identifying the right timing to initiate ECMO, as well as outline pros and cons for peripheral vs. central cannulation. We will present predictors of mortality and, very importantly, predictors of survival: what can be done to improve the outcomes for your patients. Furthermore, an overview of current insights regarding supportive care in neonatal cardiac ECMO is given. Additionally, we will address issues specific to neonates with single ventricle physiology on ECMO, for example cannulation strategies and the influence of shunt type (Blalock-Taussig shunt vs. “right ventricle to pulmonary artery” shunt). We will not only focus on short term outcomes, such as hospital survival, but also on the importance of long-term neuro-developmental outcomes, and we will end this review with suggestions for future research.

show abstract

“…In pediatrics, central cannulation via the mediastinum is accompanied by peripheral cannulation via the right internal jugular vein and the right common carotid artery. Although carotid artery dissection in the context of VA-ECMO is uncommon, it has been previously described [8]. In the acute setting of dissection, antithrombotic and antiplatelet therapy should be continued.…”

Section: Figure 1: Dilated Left Main Coronary Arterymentioning

confidence: 99%

Carotid Artery Dissection and Hemorrhagic Stroke in the Setting of Multisystem Inflammatory Syndrome in Children

Salik

Jacoby

2021

Cureus

View full text Add to dashboard Cite

An alarming and distressing delayed inflammatory response to Coronavirus Disease 2019 (COVID-19) has emerged in children and adolescents, a population previously thought to have been largely spared by this global pandemic. In April 2020, clinicians in the United Kingdom identified eight cases of previously healthy children testing positive for current or recent infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) presenting with Kawasaki disease-like features. From April 16 to May 4, 2020, New York City reported that 15 patients aged 2-15 years were hospitalized with a similar multisystem inflammatory syndrome, many requiring intensive care unit (ICU) admission. This syndrome is referred to either as pediatric inflammatory multisystem syndrome, or multisystem inflammatory syndrome in children (MIS-C). We present the case of an eight-year-old with MIS-C who developed carotid artery dissection following venoarterial extracorporeal membrane oxygenation (VA-ECMO) cannulation, followed by a subsequent hemorrhagic stroke in the basal ganglia.

show abstract

Carotid Artery Dissection Following Neck Cannulation for Extracorporeal Life Support

Cited by 7 publications

References 9 publications

Pediatric Extracorporeal Life Support Transport in Western Canada: Experience over 14 years

Pediatric Extracorporeal Life Support Transport in Western Canada: Experience over 14 years

Neonatal Cardiac ECMO in 2019 and Beyond

Carotid Artery Dissection and Hemorrhagic Stroke in the Setting of Multisystem Inflammatory Syndrome in Children

Contact Info

Product

Resources

About