Venovenous Extracorporeal Life Support in Neonates Using a Double Lumen Catheter

Complications and mortality of venovenous extracorporeal membrane oxygenation in the treatment of neonatal respiratory failure: a systematic review and meta-analysis

“…Moreover, many studies have showed that VV ECMO compared favorably to VA ECMO for cardiovascular support [27][28]. Several other previous studies have also showed that VV ECMO was associated to lower rates of neurologic complications as compared with VA ECMO [23,[29][30]. Some potential advantages of VV ECMO over VA ECMO might explain the results.…”

“…Since a double-lumen catheter was designed in 1989, VV ECMO was increasingly used in neonatal respiratory failure, and ligation of the carotid artery was avoided [23][24]. Over the years, many studies have reported the benefits of VV ECMO for neonatal respiratory failure.…”

Extracorporeal membrane oxygenation: a breakthrough for respiratory failure

“…If two cannulas are used, most centres prefer to drain blood from the IVC through a cannula placed in the groin and to infuse blood into the right atrium through a cannula inserted into the internal jugular vein, as this yields less recirculation than pumping in the other direction [32,33] although right atrium to IVC bypass may also provide good results [34]. If a single, double-lumen cannula is used, the infusion jet from the cannula is directed towards the tricuspid valve to minimize recirculation and has been successful in all age groups [35,36]. In v-a ECMO, blood is mostly returned to the right common carotid artery in neonates and to the femoral artery in older children and adults [37].…”

Extracorporeal membrane oxygenation for newborns with gastric rupture

“…Our main ECMO mode was changed in 1994 from the traditional venoarterial (VA) to the newer venovenous (VV) mode using a double-lumen catheter and adding a supplemental cephalad catheter [2]. The activated clotting time (ACT) was usually regulated using heparin to 180±210 s. When major hemorrhagic complications occurred, anticoagulation was changed from heparin alone to combined use with nafamostat mesilate (Torii Tokyo), a thrombin inhibitor with a very short half-life, in order to create a dierence in ACT values between the patient and the ECMO circuit by lowering the patient's value to 150±170 s while keeping the ECMO circuit at the usual level [15].…”