Delaying Decannulation After Extracorporeal Membrane Oxygenation Is Safe and Advantageous

World Journal for Pediatric & Congenital Heart Surgery
Jess L ThompsonHarold M Burkhart

Abstract

Removal of extracorporeal membrane oxygenation (ECMO) cannulae and discontinuing systemic anticoagulation typically occurs soon after separation from ECMO. We have found, however, that delaying decannulation after terminating ECMO therapy does not predispose to adverse outcomes and may be advantageous. Between January 2014 and June 2016, 36 postcardiotomy patients at the Children's Hospital of Oklahoma required ECMO. In this cohort of 36 patients, there was a need for 42 ECMO runs. Of the 42 ECMO runs, 29 (69%) survived to decannulation. Of those ECMO runs that survived to decannulation, 18 (62%) were cannulated centrally and 11 (38%) were cannulated via the neck. For the runs where the patient survived to decannulation, the mean number of days on ECMO support was 4 ± 2 days. There was an average time interval of 21 ± 14 hours from ECMO termination to decannulation. A single patient failed being separated from ECMO support and required reinstitution of ECMO 18 hours after separation (but did not require recannulation).

References

Apr 10, 2009·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Bahaaldin AlsoufiGlen S Van Arsdell
Jul 20, 2010·The Journal of Thoracic and Cardiovascular Surgery·T K Susheel KumarAchintya Moulick
Apr 26, 2011·The Annals of Thoracic Surgery·Jeffrey ShuhaiberFrank Pigula
Sep 25, 2014·ASAIO Journal : a Peer-reviewed Journal of the American Society for Artificial Internal Organs·Brian W GrayRobert H Bartlett
Dec 16, 2017·Journal of Pediatric Surgery·Alejandro V GarciaDaniel Rhee

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Citations

Nov 2, 2019·Journal of Pediatric Surgery·Mercedes PilkingtonSamir K Gadepalli

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