Bedside veno-venous ECMO cannulation: A pertinent strategy during the COVID-19 pandemic

Journal of Cardiac Surgery
Domenico CalcaterraMatthew E Prekker

Abstract

Patient selection and cannulation arguably represent the key steps for the successful implementation of extracorporeal membrane oxygenation (ECMO) support. Cannulation is traditionally performed in the operating room or the catheterization laboratory for a number of reasons, including physician preference and access to real-time imaging, with the goal of minimizing complications and ensuring appropriate cannula positioning. Nonetheless, the patients' critical and unstable conditions often require emergent initiation of ECMO and preclude the safe transport of the patient to a procedural suite. Therefore, with the objective of avoiding delay with the initiation of therapy and reducing the hazard of transport, we implemented a protocol for bedside ECMO cannulation. A total of 89 patients required ECMO support at Hennepin County Medical Center between March 2015 and December 2019. Twenty-eight (31%) required veno-venous support and were all cannulated at the bedside. Overall survival was 71% with no morbidity or mortality related to the cannulation procedure. In the current pandemic, the strategy of veno-venous bedside cannulation may have additional benefits for the care of patients with refractory acute respiratory distress syndr...Continue Reading

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Citations

Aug 8, 2021·Molecules : a Journal of Synthetic Chemistry and Natural Product Chemistry·Eliav BlumArie Gruzman

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Methods Mentioned

BETA
X‐ray
imaging technique

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