Original scientific paper
Veno-venous two-site cannulation versus veno-venous double lumen ECMO: complications and survival in infants with respiratory failure
MICHAEL M HERMON
orcid.org/0000-0002-9357-2491
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
JOHANN GOLEJ
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
GEHAN MOSTAFA
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
GUDRUN BURDA
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
REGINA VARGHA
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
GERHARD TRITTENWEIN
; Division of Neonatology Pediatric Intensive Care and Neuropediatrics, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria
Abstract
Objective. To compare complications and survival between the two-site veno-venous versus the veno-venous double lumen extracorporeal membrane oxygenation (ECMO) in infants with respiratory failure. Methods. The Extracorporeal Life Support Organization (ELSO, Ann Arbor, Michigan) provided the registry database, collected between 1999-2009 for this research project. During this period, 9086 infants 7 kg birth weight (BW) were treated with ECMO. From these children, those who were older than 32 days and received veno-venous extracorporeal membrane oxygenation (VV ECMO), were extracted for analysis. From a total of 270 infants who met the inclusion criteria, 236 infants were treated with veno-venous double lumen (VVDL) ECMO and 34 infants received VV two-site ECMO. ELSO records were reviewed for the following information: demographic data, type of ventilation, ventilator days and settings during ECMO, complications during ECMO and survival. Results. Eighty-seven percent (n=236) of infants were cannulated with VVDL and 13% (n=34) with VV two-site cannulation. Twenty-four hours after ECMO onset, ventilator settings were significantly higher in the VV two-site group. Median ECMO duration was significantly shorter in the VV two-site group (137(90/208) vs. 203(128/336) hours, p=0.01). Total complication rate and survival rates (71% in the VVDL group and 56% in the VV two-site group) were not significantly different. Conclusion. Both cannulation modes for ECMO are safe for use in infants with respiratory failure. The decision regarding which technique should be used for this group of patients depends mainly on best practice experience of the individual ECMO center and on the technical equipment routinely used by the center.
Keywords
ECMO; infants; respiratory failure; complications; survival
Hrčak ID:
108707
URI
Publication date:
1.10.2012.
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