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http://dx.doi.org/10.5090/kjtcs.2020.53.3.132

Extracorporeal Membrane Oxygenation in Pediatric Patients with Respiratory Failure: Early Experience with the Double-Lumen Cannula Over 2 Years  

Kim, Woojung (Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Kwon, Hye Won (Department of Pediatrics, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Min, Jooncheol (Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Cho, Sungkyu (Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Kwak, Jae Gun (Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Kim, Woong Han (Department of Thoracic and Cardiovascular Surgery, Seoul National University Children's Hospital, Seoul National University College of Medicine)
Publication Information
Journal of Chest Surgery / v.53, no.3, 2020 , pp. 132-139 More about this Journal
Abstract
Background: The double-lumen cannula (DLC) has begun to be used worldwide for venovenous (VV) extracorporeal membrane oxygenation (ECMO). We aimed to examine whether the DLC could be an effective tool in the treatment of pediatric respiratory failure in Korea. Methods: We reviewed the records of patients weighing under 15 kg who underwent ECMO due to respiratory failure between January 2017 and December 2018. Outcomes of ECMO using a DLC and conventional ECMO using central method or 2 peripheral cannulas were compared. Results: Twelve patients were treated with ECMO for respiratory failure. Among them, a DLC was used in 5 patients, the median age of whom was 3.8 months (interquartile range, 0.1-49.7 months). In these patients, the median values of pH, partial pressure of carbon dioxide, and partial pressure of oxygen were 7.09, 74 mm Hg, and 37 mm Hg before ECMO and corrected to 7.31, 44 mm Hg, and 85 mm Hg, respectively, after ECMO cannulation. Median blood flow rate in the patients treated with ECMO using a DLC was slightly higher than that in the conventional ECMO group, but this difference was not statistically significant (86.1 mL/kg/min and 74.3 mL/kg/min, respectively; p=1.00). One patient from the DLC group and 3 patients from the conventional group were weaned off ECMO. Conclusion: VV ECMO using a DLC provided adequate oxygenation, ventilation, and blood flow rate in Korean pediatric patients with respiratory failure. Further prospective and randomized studies are warranted.
Keywords
Extracorporeal membrane oxygenation; Respiratory insufficiency; Pediatrics;
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1 Salazar PA, Blitzer D, Dolejs SC, Parent JJ, Gray BW. Echocardiographic guidance during neonatal and pediatric jugular cannulation for ECMO. J Surg Res 2018;232:517-23.   DOI
2 Ellis WC, Schafer M, Barrett CS, et al. Vascular anatomical considerations and clinical decision making during insertion of the Avalon( R) Elite Dual Lumen single-site veno-venous ECMO cannula in children weighing less than 20 kg. Perfusion 2019;34:267-71.   DOI
3 Moscatelli A, Febbo F, Buratti S, et al. Intensivists performed percutaneous bicaval double-lumen echo-guided extracorporeal membrane oxygenation cannulation at bedside in newborns and children: a retrospective analysis. Pediatr Crit Care Med 2019;20:551-9.   DOI
4 Carpenter JL, Yu YR, Cass DL, et al. Use of venovenous ECMO for neonatal and pediatric ECMO: a decade of experience at a tertiary children's hospital. Pediatr Surg Int 2018;34:263-8.   DOI
5 Bartlett RH, Gazzaniga AB, Huxtable RF, Schippers HC, O'Connor MJ, Jefferies MR. Extracorporeal circulation (ECMO) in neonatal respiratory failure. J Thorac Cardiovasc Surg 1977;74:826-33.   DOI
6 Short BL, Walker LK, Traystman RJ. Impaired cerebral autoregulation in the newborn lamb during recovery from severe, prolonged hypoxia, combined with carotid artery and jugular vein ligation. Crit Care Med 1994;22:1262-8.   DOI
7 Bermudez CA, Rocha RV, Sappington PL, Toyoda Y, Murray HN, Boujoukos AJ. Initial experience with single cannulation for venovenous extracorporeal oxygenation in adults. Ann Thorac Surg 2010;90:991-5.   DOI
8 Javidfar J, Brodie D, Wang D, et al. Use of bicaval dual-lumen catheter for adult venovenous extracorporeal membrane oxygenation. Ann Thorac Surg 2011;91:1763-9.   DOI
9 Kim H, Yang JH, Cho YH, Jun TG, Sung K, Han W. Outcomes of extracorporeal membrane oxygenation in children: an 11-year single-center experience in Korea. Korean J Thorac Cardiovasc Surg 2017;50:317-25.   DOI
10 Clavien PA, Barkun J, de Oliveira ML, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187-96.   DOI
11 Speggiorin S, Robinson SG, Harvey C, et al. Experience with the Avalon(R) bicaval double-lumen veno-venous cannula for neonatal respiratory ECMO. Perfusion 2015;30:250-4.   DOI
12 Berdajs D. Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation: Avalon(c) cannula in childhood disease. Perfusion 2015;30:182-6.   DOI
13 Extracorporeal Life Support Organization. ECLS registry report: international summary. Ann Arbor (MI): Extracorporeal Life Support Organization; 2016.
14 Rollins MD, Hubbard A, Zabrocki L, Barnhart DC, Bratton SL. Extracorporeal membrane oxygenation cannulation trends for pediatric respiratory failure and central nervous system injury. J Pediatr Surg 2012;47:68-75.   DOI
15 Skinner SC, Hirschl RB, Bartlett RH. Extracorporeal life support. Semin Pediatr Surg 2006;15:242-50.   DOI
16 Jarboe MD, Gadepalli SK, Church JT, Arnold MA, Hirschl RB, Mychaliska GB. Avalon catheters in pediatric patients requiring ECMO: placement and migration problems. J Pediatr Surg 2017:S0022-3468(17)30658-9.
17 Hamilton HC, Foxcroft DR. Central venous access sites for the prevention of venous thrombosis, stenosis and infection in patients requiring long-term intravenous therapy. Cochrane Database Syst Rev 2007;(3):CD004084.
18 Kuhl T, Michels G, Pfister R, Wendt S, Langebartels G, Wahlers T. Comparison of the Avalon dual-lumen cannula with conventional cannulation technique for venovenous extracorporeal membrane oxygenation. Thorac Cardiovasc Surg 2015;63:653-62.   DOI
19 Fallon SC, Shekerdemian LS, Olutoye OO, et al. Initial experience with single-vessel cannulation for venovenous extracorporeal membrane oxygenation in pediatric respiratory failure. Pediatr Crit Care Med 2013;14:366-73.   DOI
20 Extracorporeal Life Support Organization. ECLS registry report: international summary. Ann Arbor (MI): Extracorporeal Life Support Organization; 2018.
21 Subramanian S, Vafaeezadeh M, Parrish AR, McMullan DM. Comparison of wire-reinforced and non-wire-reinforced dual-lumen catheters for venovenous ECMO in neonates and infants. ASAIO J 2013;59:81-5.   DOI
22 Lazar DA, Cass DL, Olutoye OO, et al. Venovenous cannulation for extracorporeal membrane oxygenation using a bicaval dual-lumen catheter in neonates. J Pediatr Surg 2012;47:430-4.   DOI
23 Gow KW, Wulkan ML, Heiss KF, et al. Extracorporeal membrane oxygenation for support of children after hematopoietic stem cell transplantation: the Extracorporeal Life Support Organization experience. J Pediatr Surg 2006;41:662-7.   DOI
24 Gow KW, Heiss KF, Wulkan ML, et al. Extracorporeal life support for support of children with malignancy and respiratory or cardiac failure: the extracorporeal life support experience. Crit Care Med 2009;37:1308-16.   DOI