Double-stage venous cannulation combined with Avalon® cannula for potential prolongation of respiratory ECMO in end-stage pulmonary disease.
Details
Serval ID
serval:BIB_27267A07F7EE
Type
Article: article from journal or magazin.
Publication sub-type
Case report (case report): feedback on an observation with a short commentary.
Collection
Publications
Institution
Title
Double-stage venous cannulation combined with Avalon® cannula for potential prolongation of respiratory ECMO in end-stage pulmonary disease.
Journal
Perfusion
ISSN
1477-111X (Electronic)
ISSN-L
0267-6591
Publication state
Published
Issued date
03/2016
Peer-reviewed
Oui
Volume
31
Number
7
Pages
593-597
Language
english
Notes
Publication types: Case Reports ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
Veno-venous extracorporeal membrane oxygenation (VV-ECMO) is a treatment option to correct blood oxygenation in cases of severe respiratory failure. However, it is time-limited and, in cases of no- recovery, it is a bridge-to-lung transplant therapy. We report our experience of two patients waiting for emergency lung transplantation under VV-ECMO using the Avalon® cannula. Both presented signs of ECMO failure after prolonged support, i.e. increased hemolysis, decreased blood flow rate and increased negative pressure of the venous inflow line, leading to an inadequate systemic oxygenation. The addition of a second venous inflow line, by the insertion of another venous femoral cannula, significantly increased blood flow rate, decreasing both centrifugal pump rotation speed and negative pressure (suction) of the venous inflow line. These hemodynamic improvements, together with reduced blood consumption, were maintained during an additional week of ECMO support. Ultimately, both patients died from multi-organ failure due to the absence of available donor organs. Few cases having been described up until now, but the addition of a second venous drainage cannula to the Avalon® system could potentially improve hemodynamic parameters and, therefore, stabilize hypoxemic patients. This may be an option to gain time in long-lasting VV-ECMO support as a potential life-saving attempt.
Keywords
Adult, Cannula, Catheterization/methods, Extracorporeal Membrane Oxygenation/methods, Humans, Lung Transplantation, Male, Middle Aged, Respiratory Distress Syndrome, Adult/therapy, Respiratory Insufficiency/therapy, Young Adult
Pubmed
Create date
09/04/2016 15:20
Last modification date
20/08/2019 13:06