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

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.