Hybrid Extracorporeal Membrane Oxygenation Using Avalon Elite Double Lumen Cannula Ensures Adequate Heart/Brain Oxygen Supply

The Annals of Thoracic Surgery
Ju ZhaoJoseph B Zwischenberger

Abstract

Differential hypoxia exists in peripheral venoarterial (VA) extracorporeal membrane oxygenation (ECMO) patients with compromised lungs, causing hypoxic damage to heart or brain. We proposed an Avalon Elite (Maquet, Rastatt, Germany) double lumen cannula-based hybrid ECMO to add a venovenous (VV) blood flow into the pulmonary circulation onto the existing VA ECMO circuit to increase oxygen saturation in the left ventricle and ascending aorta, mitigating heart/brain hypoxia. This hybrid ECMO circuit consists of two cannulas (27F Avalon Elite double lumen cannula from the inferior vena cava to the superior vena cava to right atrium to inferior vena cava; 17F infusion cannula in femoral artery), a blood pump, and a gas exchanger. This hybrid ECMO circuit was tested in 7 adult sheep with simulated lung failure. Total ECMO blood flow (2.8 to 3.3 L/min) was split between VV and VA blood flow. The VV blood flow was adjusted from 0% to 50% of total ECMO flow by approximately 10% increments. In VA ECMO, simulated respiratory failure resulted in differential hypoxia (low oxygen level in left ventricle and high oxygen level in abdominal aorta). In hybrid ECMO, adding VV blood flow (10% to 50% of total ECMO flow) to the VA ECMO circuit prog...Continue Reading

Citations

May 11, 2021·Indian Journal of Thoracic and Cardiovascular Surgery : Official Organ, Association of Thoracic and Cardiovascular Surgeons of India·Vanessa Marie BazanJoseph Bertram Zwischenberger
Aug 18, 2021·JTCVS Techniques·Aakash ShahDavid J Kaczorowski

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