Outcomes by cannulation methods for venovenous extracorporeal membrane oxygenation during COVID‐19: A multicenter retrospective study

Abstract

In a multicenter, retrospective analysis of 435 patients with refractory COVID‐19 placed on V‐V ECMO, cannulation by a single, dual‐lumen catheter with directed outflow to the pulmonary artery was associated with lower inpatient mortality.

Prognostic factors associated with mortality among patients receiving venovenous extracorporeal membrane oxygenation for COVID-19: a systematic review and meta-analysis

“…Of 2888 studies identified ( figure ), we selected 123 for full-text review. We included 42 observational cohort studies 13 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 involving 17 449 patients ( table 1 ), predominantly from North America or Europe. We did not identify any randomised controlled trials that met our eligibility criteria.…”

The ProtekDuo in ECMO configuration for ARDS secondary to COVID-19: A systematic review

“…The ProtekDuo showed survival rates between 59 and 89% throughout the five studies and was suggestive for a survival benefit when compared to an invasive ventilation group 9 or compared to dual site V-V ECMO or other double-lumen ECMO cannulas. 10 One study focused on extubation and discontinuation of ventilator support, which could be achieved in 100% of ProtekDuo patients. 8 In addition, an association of reduced incidence of acute kidney injury (AKI) and consecutive use of continuous renal replacement therapy (CRRT) could be demonstrated when the ProtekDuo was used ( Table 2 ).…”

“…In 2022, a large multicenter retrospective study including 435 adult patients was published by Saeed et al 10 This group compared the dual-site versus single-site cannulation approach. For dual site they used femoral vein to femoral vein or femoral vein to internal jugular vein access.…”

The ProtekDuo cannula for extracorporeal membrane oxygenation: A game changer in COVID‐19!

“…The major finding of this study was an in-hospital mortality of 60% for patients who had dual site ECMO compared to 41% for patients with a ProtekDuo. 6 The benefits of the ProtekDuo cannula appear to come from its default V-P position with drainage of venous blood in the right atrium (RA, inflow or proximal lumen) and return of arterialized blood into the pulmonary artery (P, outflow or distal lumen), when an oxygenator is added to the circuit. By bypassing the right ventricle (RV) it serves as both RVAD and as double lumen ECMO cannula.…”

“…The major finding of this study was an in‐hospital mortality of 60% for patients who had dual site ECMO compared to 41% for patients with a ProtekDuo. 6 …”