The peripheral cannulas in extracorporeal life support

Abstract

Femoral cannulation is a minimally invasive method which is an alternative method for central cannulation. This review focuses on the parameters and features of the available peripheral cannulas. Nowadays there exist many peripheral cannulas in a variety of sizes, configurations and lengths to meet the specific needs of the patients. Modern cannulas are strong, thin-walled and one piece reinforced constructions. Furthermore, modern cannulas are manufactured from a biocompatible material and surface coatings are applied to the cannulas to reduce the activation of the clotting. When peripheral cannulas are applied, bleeding, thrombosis and hemolysis are the most common complications.

Factors associated with hemolysis during extracorporeal membrane oxygenation (ECMO)—Comparison of VA- versus VV ECMO

“…Small cannulas and high ECMO blood flow may induce hemolysis [15]. VA-and VV ECMO used different initial cannulation strategies (Table 3).…”

Intraoperative Management of Adult Patients on Extracorporeal Membrane Oxygenation: An Expert Consensus Statement From the Society of Cardiovascular Anesthesiologists—Part I, Technical Aspects of Extracorporeal Membrane Oxygenation

“…Modern ECMO cannulas are made from polyurethane and are lined with biocompatible hydrophilic coatings, which contain covalently bonded heparin, albumin, or sulfate. 58 Examples of biocompatible coatings include Bioline (Getinge Group), Smart-X (Sorin), and Trilium (Medtronic). The purpose of these coatings is to limit protein adsorption and coagulation system activation when blood comes into contact with artificial hydrophobic surfaces, such as circuit tubing.…”

Suporte Respiratório Extracorpóreo Em Pacientes

“…Além disso, a proporção de pacientes que apresentaram altos valores de hemoglobina durante a ECMO foi maior para o ECMO VA. Esses pacientes necessitaram de quantidades maiores de derivados do sangue (por um fator de 2,5 a mais de hemácias). Um estudo retrospectivo demonstrou que a transfusão de hemácias durante a ECMO foi associada a complicações graves (complicações tromboembólicas, sepse, hemólise) (MEHTA et al, 2015;STRUNINA et al, 2019).…”