Percutaneous Cannulation for Extracorporeal Membrane Oxygenation by Intensivists

Conrad, Steven A.; Grier, Laurie; Scott, L. Keith; Green, Rebecca; Jordan, Mary

doi:10.1097/ccm.0000000000000883

Cited by 101 publications

(87 citation statements)

References 31 publications

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“…Transthoracic central or carotid artery cannulation was not performed. Peripheral cannulation was done in all patients, and all these procedures were performed by both simultaneous cardiothoracic surgeons and intensivists [25]. A venous cannula was placed just below the right atrium through the femoral vein, and an arterial cannula was placed in the iliac artery via the femoral artery using the Seldinger technique under the guidance of ultrasound [26].…”

Section: Methodsmentioning

confidence: 99%

Advanced Age as a Predictor of Survival and Weaning in Venoarterial Extracorporeal Oxygenation: A Retrospective Observational Study

Lee

Kim

Choi

et al. 2017

BioMed Research International

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Background. In most reports on ECMO treatment, advanced age is classified as a contraindication to VA ECMO. We attempted to investigate whether advanced age would be a main risk factor deciding VA ECMO application and performing VA ECMO support. We determined whether advanced age should be regarded as an absolute or relative contraindication to VA ECMO and could affect weaning and survival rates of VA ECMO patients. Methods. VA ECMO was performed on 135 adult patients with primary cardiogenic shock between January 2010 and December 2014. Successful weaning was defined as weaning from ECMO followed by survival for more than 48 hours. Results. Among the 135 patients, 35 survived and were discharged uneventfully, and the remaining 100 did not survive. There were significant differences in survival between age groups, and older age showed a lower survival rate with statistical significance (P = .01). By multivariate logistic regression analysis, age was not significantly associated with in-hospital mortality (P = .83) and was not significantly associated with VA ECMO weaning (P = .11). Conclusions. Advanced age is an undeniable risk factor for VA ECMO; however, patients of advanced age should not be excluded from the chance of recovery after VA ECMO treatment.

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Section: Methodsmentioning

confidence: 99%

Advanced Age as a Predictor of Survival and Weaning in Venoarterial Extracorporeal Oxygenation: A Retrospective Observational Study

Lee

Kim

Choi

et al. 2017

BioMed Research International

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“…The size of the venous drainage cannula is a determining factor for blood flow in the ECMO circuit; therefore, the insertion in the largest cannula should be attempted. The diameter of the vessels measured by ultrasound may aid in the choice of cannula size (22). From a practical standpoint, this anatomical evaluation is rarely performed in daily clinical practice before VV-ECMO implantation considering the critical state of these patients.…”

Section: Patient Assessment Prior To Cannulationmentioning

confidence: 99%

Veno-venous extracorporeal membrane oxygenation: cannulation techniques

et al. 2016

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The development of extracorporeal membrane oxygenation (ECMO) technology allows a new approach for the intensive care management of acute cardiac and/or respiratory failure in adult patients who are not responsive to conventional treatment. Current ECMO therapies provide a variety of options for the multidisciplinary teams who are involved in the management of these critically ill patients. In this regard, veno-venous ECMO (VV-ECMO) can provide quite complete respiratory support, even if this highly complex technique presents substantial risks, such as bleeding, thromboembolic events and infection.While VV-ECMO circuits usually include the cannulation of two vessels (double cannulation) in its classic configuration, the use of a single cannula is now possible for VV-ECMO support. Recently, experienced centers have employed more advanced approaches by cannulating three vessels (triple cannulation) which follows veno-arterio-venous (VAV) or veno-arterio-pulmonary-arterial cannulation (VAPa). However, 'triple' cannulation expands the field of application but increases the complexity of ECMO systems. In the present review, the authors focus on the indications for VV-ECMO, patient assessment prior to cannulation, the role of ultrasound-guided vessel puncture, double lumen single bicaval cannulations, and finally triple cannulation in VV-ECMO.

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“…It has traditionally been performed with an open, surgical access procedure by cardiac surgeons (18). With newer vascular cannulae and insertion kits, peripheral VA-ECMO can now be implanted with a percutaneous approach, allowing for a close collaboration between cardiac surgeons, emergency department physicians, intensivists and cardiologists (19).…”

Section: Peripheral Va-ecmomentioning

confidence: 99%

Veno-arterial extracorporeal membrane oxygenation: an overview of different cannulation techniques

Banfı¹,

Pozzi²,

Brunner³

et al. 2016

J. Thorac. Dis.

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Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has known a widespread application over the last decade and is now an effective and valuable therapeutic option in refractory cardiogenic shock of various etiologies. In this subgroup of critically ill and unstable patients in cardiogenic shock, VA-ECMO allows, on the one hand, temporary hemodynamic stabilization with improvement of endorgan function and, on the other hand, gives the time to perform complementary diagnostic exams and to decide the therapeutic strategy in these high-risk candidates for immediate long-term mechanical circulatory support (MCS) implantation. VA-ECMO could also be suggested as a rescue therapeutic option for refractory cardiac arrest. It showed promising results in the specific setting of in-hospital cardiac arrest and survival rates with good neurological outcome are reported between 20% and 40%. Conversely, there are contrasting data in the literature about survival after VA-ECMO for out-of-hospital cardiac arrest, as results are highly dependent on low-flow time. The aim of the present report is to offer an overview of different cannulation techniques of VA-ECMO.

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Percutaneous Cannulation for Extracorporeal Membrane Oxygenation by Intensivists

Abstract: Percutaneous cannulation for extracorporeal membrane oxygenation by intensivists can be performed with a high rate of success and a low rate of complications when accompanied by imaging support.

Cited by 101 publications

References 31 publications

Advanced Age as a Predictor of Survival and Weaning in Venoarterial Extracorporeal Oxygenation: A Retrospective Observational Study

Advanced Age as a Predictor of Survival and Weaning in Venoarterial Extracorporeal Oxygenation: A Retrospective Observational Study

Veno-venous extracorporeal membrane oxygenation: cannulation techniques

Veno-arterial extracorporeal membrane oxygenation: an overview of different cannulation techniques

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