Successful Treatment of Refractory Status Asthmaticus Accompanied by Right Ventricular Dysfunction Using a Protek Duo Tandem Heart Device

Hill, Graham; Traudt, Ryan J.; Durham, Lucian A.; Pagel, Paul S.; Tawil, Justin N.

doi:10.1053/j.jvca.2019.03.031

Cited by 7 publications

(9 citation statements)

References 25 publications

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“…Most recent evidence of the use of the cannula in RV/ECMO support was in a 44-year old with status asthmaticus. 6 Another advantage of the TPD cannula is the lowering of recirculation-related hypoxia. In our patient, the recirculation percentage was as high as 70% with the Avalon cannula.…”

Section: Discussionmentioning

confidence: 99%

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Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

et al. 2020

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Rescuing patients with the development of acute respiratory distress syndrome and right heart failure after left ventricular assist device placement remains a challenge in patients with congenital heart disease. TandemLife Protek Duo (TandemLife, Pittsburg, PA) is a double-lumen cannula introduced via the internal jugular vein that can provide veno-venous extra-corporeal membrane oxygenation and right heart support. To our knowledge, we report the first case of successfully using the TandemLife Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricle support in an adolescent male with an existing right ventricle-pulmonary artery conduit and the melody pulmonary valve who developed severe acute respiratory distress syndrome after the placement of left ventricular assist device. The stability of the cannula enabled minimal recirculation-related hypoxia events, early mobilization, and ambulation. Our patient was discharged home after lung recovery and currently awaiting a heart transplant.

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Section: Discussionmentioning

confidence: 99%

“…Most recent evidence of the use of the cannula in RV/ECMO support was in a 44-year old with status asthmaticus. 6…”

Section: Discussionmentioning

confidence: 99%

Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

et al. 2020

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“…The Protek Duo (TandemLife, Pittsburgh, Pennsylvania) is a temporary, percutaneous RVAD, placed via the right internal jugular vein, draining blood from the right atrium, and returning it to the pulmonary artery. 63 This device has been used in patients with various etiologies of RV failure, including post-ventricular assist device (LVAD) implantation 64 and secondary to status asthmaticus. 63 This device avoids a sternotomy while also preventing recirculation due to the intervening tricuspid and pulmonic valves between the drainage and return.…”

Section: Additional Mechanical Support Devices For Rv Supportmentioning

confidence: 99%

“…63 This device avoids a sternotomy while also preventing recirculation due to the intervening tricuspid and pulmonic valves between the drainage and return. 63…”

Section: Additional Mechanical Support Devices For Rv Supportmentioning

confidence: 99%

“…63 This device has been used in patients with various etiologies of RV failure, including post-ventricular assist device (LVAD) implantation 64 and secondary to status asthmaticus. 63 This device avoids a sternotomy while also preventing recirculation due to the intervening tricuspid and pulmonic valves between the drainage and return. 63 These devices can allow mobility and offer stability as compared to VA-ECMO, yet they mandate the patient to remain in the hospital.…”

Section: Right Ventricular Assist Devicesmentioning

confidence: 99%

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ECMO and Right Ventricular Failure: Review of the Literature

Grant¹,

Richards

Frakes³

et al. 2020

J Intensive Care Med

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Right ventricular (RV) failure is the inability of the RV to maintain sufficient cardiac output in the setting of adequate preload, due to either intrinsic injury to the RV or increased afterload. Medical treatment of RV failure should include optimizing preload, augmenting contractility with vasopressors and inotropes, and considering inhaled pulmonary vasodilators. However, when medical therapies are insufficient, mechanical circulatory support (MCS) is needed to maintain systemic and RV perfusion. The data on MCS for isolated RV failure are limited, but extracorporeal membrane oxygenation (ECMO) appears to be the most efficient and effective modality. For patients with isolated RV failure from acute hypoxemic respiratory failure, veno-venous (VV) ECMO is an appropriate initial configuration, even if the patient is in shock. With primary RV injury or RV failure with concomitant left ventricle (LV) failure, however, venoarterial (VA) ECMO is indicated. Both modalities provide indirect support to the RV by reducing preload, reducing RV wall tension, and delivering oxygenated blood to the coronary circulation. Peripheral cannulation is required in VV-ECMO and is most commonly used in VA-ECMO, allowing for rapid cannulation even in emergencies. Changes in pulsatility on an arterial catheter waveform can indicate changes in clinical status including changes in myocardial function, inadequate preload, worsening RV failure, and excessive VA-ECMO support leading to an elevated LV afterload. Myocardial function may be improved by titration of inotropes or vasodilators, utilization of an Impella or an intra-aortic balloon counterpulsation support devices, or by changes in VA-ECMO support.

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Treatment of Perioperative Ischemia, Infarction, and Ventricular Failure in Cardiac Surgery

Bishawi¹,

Milano²

2022

Perioperative Medicine

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Successful Treatment of Refractory Status Asthmaticus Accompanied by Right Ventricular Dysfunction Using a Protek Duo Tandem Heart Device

Cited by 7 publications

References 25 publications

Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

Successful use of Protek Duo cannula to provide veno-venous extra-corporeal membrane oxygenation and right ventricular support for acute respiratory distress syndrome in an adolescent with complex congenital heart disease

ECMO and Right Ventricular Failure: Review of the Literature

Treatment of Perioperative Ischemia, Infarction, and Ventricular Failure in Cardiac Surgery

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