Abstract：
BACKGROUND: Bicaval dual lumen cannula (DLC) is gaining popularity in veno-venous extracorporeal membrane oxygenation (V-V ECMO) for having less recirculation and facilitating mobilization. It is usually inserted under fluoroscopic or transesophageal echocardiographic guidance to prevent potentially fatal complications. Thus, their utilization was limited during the COVID-19 outbreak due to stringent quarantine policy and manpower shortage, especially when emergency insertion was required.
OBJECTIVE: To describe our experience on DLC insertion using transthoracic echocardiography alone during the pandemic, with a focus on safety considerations by using detail step-by-step procedural guide.
RESULTS: Four patients were performed V-V ECMO using the transthoracic echocardiographic-guided DLC cannulation technique during the fifth wave of the COVID-19 outbreak, with no cannulation-related complications.
CONCLUSIONS: Transthoracic echocardiographic guidance for DLC insertion is feasible and probably safe with a detailed guide, which can be adopted as a supplementary tool during future endemic outbreaks.
OBJECTIVE: To describe our experience on DLC insertion using transthoracic echocardiography alone during the pandemic, with a focus on safety considerations by using detail step-by-step procedural guide.
RESULTS: Four patients were performed V-V ECMO using the transthoracic echocardiographic-guided DLC cannulation technique during the fifth wave of the COVID-19 outbreak, with no cannulation-related complications.
CONCLUSIONS: Transthoracic echocardiographic guidance for DLC insertion is feasible and probably safe with a detailed guide, which can be adopted as a supplementary tool during future endemic outbreaks.
摘要：
背景：双腔双腔插管（DLC）在静脉-静脉体外膜氧合（V-VECMO）中越来越受欢迎，因为它具有较少的再循环和促进动员。通常在透视或经食道超声心动图引导下插入，以防止潜在的致命并发症。因此，由于严格的检疫政策和人力短缺，它们的利用在COVID-19疫情期间受到限制，特别是当需要紧急插入时。
目的：描述我们在大流行期间仅使用经胸超声心动图进行DLC插入的经验，通过使用详细的分步程序指南，重点关注安全考虑。
结果：在COVID-19爆发的第五波中，4例患者使用经胸超声心动图引导的DLC插管技术进行了V-VECMO，没有插管相关的并发症。
结论：经胸超声心动图指导DLC插入是可行的，并且有详细的指导可能是安全的，它可以作为未来地方性疫情期间的补充工具。
目的：描述我们在大流行期间仅使用经胸超声心动图进行DLC插入的经验，通过使用详细的分步程序指南，重点关注安全考虑。
结果：在COVID-19爆发的第五波中，4例患者使用经胸超声心动图引导的DLC插管技术进行了V-VECMO，没有插管相关的并发症。
结论：经胸超声心动图指导DLC插入是可行的，并且有详细的指导可能是安全的，它可以作为未来地方性疫情期间的补充工具。
