A multidisciplinary approach to VA ECMO cannulation in children
| Autor: | Kamlesh Kukreja, Matthew Musick, James A. Thomas, Emile I. Gleeson, Adam M. Vogel, Gregory C. Gardner, Megan E. Cunningham, Cole Burgman |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Percutaneous Adolescent medicine.medical_treatment 03 medical and health sciences Extracorporeal Membrane Oxygenation 0302 clinical medicine 030225 pediatrics Catheterization Peripheral Pediatric surgery medicine Extracorporeal membrane oxygenation Limb perfusion Humans Child medicine.diagnostic_test business.industry Interventional radiology General Medicine Cannula Surgery Femoral Artery Catheter surgical procedures operative 030220 oncology & carcinogenesis Pediatrics Perinatology and Child Health Female business Perfusion |
| Zdroj: | Journal of Pediatric Surgery. 55:1405-1408 |
| ISSN: | 0022-3468 |
| DOI: | 10.1016/j.jpedsurg.2020.03.001 |
| Popis: | Extracorporeal membrane oxygenation (ECMO) supports gas exchange and circulation in critically ill patients. This study describes a multidisciplinary approach to ECMO cannulation using the expertise of pediatric surgery (PS) and interventional radiology (IR).Pediatric patients (18 years) undergoing percutaneous cannulation for peripheral veno-arterial (VA) ECMO by PS and IR from April 2017 to May 2018 were included. Cardiac patients and children cannulated by PS alone were excluded.Five patients were included in the series. Median age was 16 [12.5-17] years and 3 were female. Median ECMO arterial and venous catheter sizes were 19 [17-22] Fr and 25 [25-28] Fr, respectively. Both catheters were placed in the common femoral vessels. A 6Fr antegrade distal perfusion cannula (DPC) was also placed in the superficial femoral artery by IR at the time of cannulation. The median time from admission to procedure start was 10 [7-50] hours and the children were on ECMO for a median length of 3.2 [2.3-4.8] days. There were two episodes of bleeding. No patients had loss of limb circulation.A multidisciplinary approach to peripheral VA ECMO cannulation is feasible and safe. Maintenance of limb perfusion by percutaneous placement and removal of DPC may be an advantage of this collaborative approach.IV.Case series. |
| Databáze: | OpenAIRE |
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