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Related Concept Videos

Administering Oxygen by Nasal Cannula01:29

Administering Oxygen by Nasal Cannula

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Oxygen therapy is critical to patient care, especially for those struggling with respiratory issues. This intervention increases the oxygen concentration in the lungs, enhancing the amount of oxygen transported to the body's tissues. One standard method of delivering supplemental oxygen is through a nasal cannula, a non-invasive device that provides low to medium oxygen concentrations.
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Tracheostomy decannulation is a significant milestone in the liberation of mechanically ventilated patients. Despite its importance, there is no universally accepted protocol for this procedure. This demands an evidence-based, individualized approach.
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Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
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Related Experiment Video

Updated: Aug 29, 2025

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Cannulation approach and mortality in neonatal ECMO.

Jessica L Gancar1, Molly C Shields1, K Christian Walters2

  • 1Department of Pediatrics, Augusta University, Augusta, Georgia, USA.

Journal of Perinatology : Official Journal of the California Perinatal Association
|September 8, 2022
PubMed
Summary

Venovenous (VV) cannulation is linked to lower mortality in neonates on extracorporeal membrane oxygenation (ECMO) for respiratory failure compared to venoarterial (VA) cannulation. This finding holds true regardless of illness severity.

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Area of Science:

  • Neonatal Intensive Care
  • Cardiopulmonary Support
  • Pediatric Critical Care

Background:

  • Extracorporeal membrane oxygenation (ECMO) is a vital life support for neonates with severe respiratory failure.
  • The choice of cannulation approach, venovenous (VV) versus venoarterial (VA), may impact outcomes.

Purpose of the Study:

  • To investigate the association between cannulation approach and mortality in neonates receiving ECMO for respiratory failure.
  • To determine if the VA approach is associated with increased mortality compared to the VV approach, independent of illness severity.

Main Methods:

  • Retrospective analysis of 244 neonates undergoing ECMO for respiratory indications.
  • Utilized Cox Proportional Hazards (CPH) model to assess mortality risk associated with cannulation approach.
  • Adjusted for the Neo-RESCUERS score to account for illness severity.

Main Results:

  • Overall survival was 88% among the 244 neonates.
  • VA cannulation was associated with significantly higher mortality (HR 4.189) compared to VV cannulation, even after adjusting for the Neo-RESCUERS score.
  • Higher ECMO mortality with VA cannulation was observed in neonates with congenital diaphragmatic hernia and persistent pulmonary hypertension of the newborn (PPHN).

Conclusions:

  • Venoarterial (VA) cannulation is associated with increased mortality in neonates on ECMO for respiratory failure.
  • The increased mortality risk with VA cannulation is independent of the initial illness severity, as indicated by the Neo-RESCUERS score.
  • These findings suggest that the VV approach may be preferable for neonates requiring ECMO for respiratory failure.