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Airway management is a key skill in emergency and critical care settings, as maintaining a clear airway is essential for adequate oxygenation and ventilation.Head Tilt-Chin Lift TechniqueThe head tilt-chin lift maneuver is an essential technique primarily used in patients without suspected cervical spine injuries. To perform this maneuver, one hand is placed on the patient’s forehead, and gentle pressure is applied backward to tilt the head. The fingertips of the other hand are positioned...
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Related Experiment Video

Updated: Sep 24, 2025

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A Dual-Lumen Extracorporeal Membrane Oxygenation Cannulation Technique Using a Mobile X-Ray Device.

Thomas Schweiger1, Florian Ponholzer2, Daria Kifjak3

  • 1Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.

The Annals of Thoracic Surgery
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Mobile x-ray devices offer a safe, examiner-independent method for dual-lumen extracorporeal membrane oxygenation (ECMO) cannulation. This technique overcomes limitations of traditional imaging, enhancing patient safety during critical procedures.

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Area of Science:

  • Cardiovascular Surgery
  • Medical Imaging
  • Critical Care Medicine

Background:

  • Dual-lumen extracorporeal membrane oxygenation (ECMO) cannulation is a complex procedure with potential life-threatening risks.
  • Current guidance methods, ultrasound and fluoroscopy, have limitations including examiner dependence and patient transport requirements.

Purpose of the Study:

  • To evaluate the safety and efficacy of using digital, mobile x-ray devices for bedside dual-lumen ECMO cannulation.
  • To present a novel, examiner-independent imaging modality for this critical procedure.

Main Methods:

  • A retrospective analysis of 23 dual-lumen cannulations in 20 patients from November 2019 to November 2021.
  • Comparison of cannulations performed in the intensive care unit (ICU) using mobile x-ray versus those in the operating room (OR) with conventional fluoroscopy.

Main Results:

  • Twelve of 23 (52.2%) cannulations were performed in the ICU using mobile x-ray devices.
  • No cardiovascular injuries occurred in any procedure.
  • Insertion site bleeding was the most frequent complication (n=2).

Conclusions:

  • Dual-lumen cannulation guided by sequential x-rays is a safe and feasible technique.
  • This method is particularly advantageous for infectious patients or those requiring awake ECMO, overcoming limitations of existing imaging modalities.