Choice of Peripheral Venoarterial Extra-Corporeal Membrane Oxygenation Cannulation Site in Patients Above 15 kilograms

Journal of Cardiac Surgery
Mustafa KurkluogluDilip S Nath

Abstract

Extracorporeal membrane oxygenation (ECMO) is a life-saving measure for pediatric patients with cardiopulmonary failure. The option of cannulating neck vessels versus those of the groin exists for patients over 15 kg; however, each carries the risk for complications. We present a single-center experience comparing the risks and benefits of these alternate peripheral ECMO cannulation sites. All pediatric patients supported by venoarterial (VA) ECMO via peripheral cannulation from January 2006 to May 2013 were retrospectively reviewed, excluding those weighing less than 15 kg. We compared complications of neck versus groin cannulation sites, including neurologic dysfunction, limb ischemia, and in-hospital mortality. Univariate analysis and multivariable logistic regression were performed to identify factors for complications including mortality. Thirty-six patients (median age 10.8 years, interquartile range: 6.0-15.8) were cannulated for VA ECMO. Forty-four percent were cannulated via neck vessels and 47% were cannulated via groin. Nine percent were cannulated at both sites. Overall survival was 72% at decannulation and 67% at hospital discharge. No statistically significant survival difference between groin and neck cannulation...Continue Reading

References

Sep 1, 1990·The Annals of Thoracic Surgery·T R KarlR B Mee
Jul 1, 1995·The Annals of Thoracic Surgery·K L GreasonR J Moreno-Cabral
Jan 16, 2007·Journal of Cardiothoracic Surgery·Sendhil K BalasubramanianRichard K Firmin

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Citations

Aug 7, 2018·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Sarah B CairoUNKNOWN American Pediatric Surgical Association Critical Care Committee
Mar 26, 2019·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Kristen Nelson-McMillanJohn D Coulson
Jun 10, 2017·International Anesthesiology Clinics·Mahsun Yuerek, Joseph W Rossano
May 15, 2020·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Manan H DesaiCan Yerebakan
Aug 12, 2020·Clinical and Experimental Pediatrics·Silver HeinsarJohn F Fraser
May 18, 2021·Interactive Cardiovascular and Thoracic Surgery·Jaume Izquierdo-BlascoJoan Balcells
Oct 17, 2021·The Thoracic and Cardiovascular Surgeon·Udo BoekenStephan Ensminger

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