Veno-venous extracorporeal membrane oxygenation: cannulation techniques.
- Banfi C Division of Cardiovascular Surgery, Geneva University Hospitals, Geneva, Switzerland;; Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Geneva, Switzerland.
- Pozzi M Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, "Claude Bernard" University, Lyon, France.
- Siegenthaler N Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Geneva, Switzerland;; Intensive Care Service, Geneva University Hospitals, Geneva, Switzerland.
- Brunner ME Intensive Care Service, Geneva University Hospitals, Geneva, Switzerland.
- Tassaux D Intensive Care Service, Geneva University Hospitals, Geneva, Switzerland.
- Obadia JF Department of Cardiac Surgery, "Louis Pradel" Cardiologic Hospital, "Claude Bernard" University, Lyon, France.
- Bendjelid K Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Geneva, Switzerland;; Intensive Care Service, Geneva University Hospitals, Geneva, Switzerland.
- Giraud R Faculty of Medicine, University of Geneva, Geneva, Switzerland;; Geneva Hemodynamic Research Group, Geneva, Switzerland;; Intensive Care Service, Geneva University Hospitals, Geneva, Switzerland.
- 2017-02-03
Published in:
- Journal of thoracic disease. - 2016
English
The development of extracorporeal membrane oxygenation (ECMO) technology allows a new approach for the intensive care management of acute cardiac and/or respiratory failure in adult patients who are not responsive to conventional treatment. Current ECMO therapies provide a variety of options for the multidisciplinary teams who are involved in the management of these critically ill patients. In this regard, veno-venous ECMO (VV-ECMO) can provide quite complete respiratory support, even if this highly complex technique presents substantial risks, such as bleeding, thromboembolic events and infection. While VV-ECMO circuits usually include the cannulation of two vessels (double cannulation) in its classic configuration, the use of a single cannula is now possible for VV-ECMO support. Recently, experienced centers have employed more advanced approaches by cannulating three vessels (triple cannulation) which follows veno-arterio-venous (VAV) or veno-arterio-pulmonary-arterial cannulation (VAPa). However, 'triple' cannulation expands the field of application but increases the complexity of ECMO systems. In the present review, the authors focus on the indications for VV-ECMO, patient assessment prior to cannulation, the role of ultrasound-guided vessel puncture, double lumen single bicaval cannulations, and finally triple cannulation in VV-ECMO.
- Language
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- English
- Open access status
- green
- Identifiers
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- DOI 10.21037/jtd.2016.12.88
- PMID 28149575
- Persistent URL
- https://sonar.ch/global/documents/271888
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