%0 Journal Article
%T Alternative venous access sites for dual-lumen extracorporeal membrane oxygenation cannulation.
%A Schoeberl AK
%A Staudacher D
%A Kawashima M
%A Fischer C
%A Cypel M
%A Buchtele N
%A Staudinger T
%A Aigner C
%A Hoetzenecker K
%A Schweiger T
%J Interdiscip Cardiovasc Thorac Surg
%V 38
%N 4
%D 2024 Mar 29
%M 38603626
暂无%R 10.1093/icvts/ivae060
%X <B>OBJECTIVE: </B>Dual-lumen cannulas for veno-venous (VV) extracorporeal membrane oxygenation (ECMO) support are typically inserted in the right internal jugular vein (RIJV); however, some scenarios can make this venous route inaccessible. This multicentre case series aims to evaluate if single-site cannulation using an alternative venous access is safe and feasible in patients with an inaccessible RIJV.<BR><B>METHODS: </B>We performed a multi-institutional retrospective analysis including high-volume ECMO centres with substantial experience in dual-lumen cannulation (DLC) (defined as >10 DLC per year). Three centres [Freiburg (Germany), Toronto (Canada) and Vienna (Austria)] agreed to share their data, including baseline characteristics, technical ECMO and cannulation data as well as complications related to ECMO cannulation and outcome.<BR><B>RESULTS: </B>A total of 20 patients received alternative DLC for respiratory failure. Cannula insertion sites included the left internal jugular vein (n = 5), the right (n = 7) or left (n = 3) subclavian vein and the right (n = 4) or left (n = 1) femoral vein. The median cannula size was 26 (19-28) French. The median initial target ECMO flow was 2.9 (1.8-3.1) l/min and corresponded with used cannula size and estimated cardiac output. No procedural complications were reported during cannulation and median ECMO runtime was 15 (9-22) days. Ten patients were successfully bridged to lung transplantation (n = 5) or lung recovery (n = 5). Ten patients died during or after ECMO support.<BR><B>CONCLUSIONS: </B>Alternative venous access sites for single-site dual-lumen catheters are a safe and feasible option to provide veno-venous ECMO support to patients with inaccessible RIJV.