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- Title
Inferior vena cava surgical cannulation for infants needing veno-venous extracorporeal membrane oxygenation.
- Authors
Martucci, Gennaro; di Francesco, Fabrizio; Panarello, Giovanna; Piazza, Marcello; de Ville de Goyet, Jean; Arcadipane, Antonio
- Abstract
Introduction: Femoral cannulation for veno-venous extracorporeal membrane oxygenation is challenging in infants because of the diameter of the vein. Case report: Prolonged ECMO support (67 days) was necessary for an 8-month-old (8 kg) girl with acute respiratory distress syndrome that was caused by H1N1 influenza. After 30 days on ECMO support and using a single 16 Fr double-lumen cannula (internal jugular vein), a second cannula was necessary to ensure adequate flow. This second 12 Fr single-lumen cannula was surgically placed through the right common iliac vein. An excellent flow profile was then achieved and ECMO continued successfully for 37 more days. Discussion: As a lifesaving option, this double caval configuration successfully optimized the flow profile and oxygenation, outweighing the related risks. Conclusion: In small children, a surgical approach to the inferior vena cava can be considered safe, especially in those cases where there is a shortage of adequate cannulas, or when central venous access is difficult.
- Subjects
ADULT respiratory distress syndrome treatment; INFERIOR vena cava surgery; H1N1 influenza; TRACHEOTOMY; PATIENT aftercare; CHEST X rays; MEDICAL device removal; CENTRAL venous catheterization; PERIPHERALLY inserted central catheters; EXTRACORPOREAL membrane oxygenation; ADULT respiratory distress syndrome; ARTIFICIAL respiration; MEDICAL instrument maintenance; CATHETERIZATION; DISEASE complications
- Publication
Perfusion, 2022, Vol 37, Issue 2, p128
- ISSN
0267-6591
- Publication type
Article
- DOI
10.1177/0267659120987089