Extracorporeal membrane oxygenation cannula dressing and securement practices: A point prevalence study

Area of Science:

• Critical Care Medicine
• Cardiovascular Surgery
• Biomedical Engineering

Background:

• Effective securement of extracorporeal membrane oxygenation (ECMO) cannulae is crucial for preventing complications like migration, dislodgement, and infection.
• Current practices lack evidence-based guidelines, necessitating an understanding of existing methods.

Purpose of the Study:

• To describe current practices for dressing and securing ECMO cannulae and circuit tubing in Australia and New Zealand.

Main Methods:

• A prospective, observational point prevalence study was conducted over 12 months in 11 centers.
• Data were collected on all eligible patients receiving ECMO during 12 distinct periods.

Main Results:

• Transparent semipermeable dressings were common for peripherally inserted cannulae.
• Sutures were frequently used for central cannulae in pediatric patients, while sutureless devices were common for circuit tubing.
• Despite most centers having guidelines, adherence was low (12% for insertion sites, 6% for tubing).

Conclusions:

• Significant variation exists in ECMO cannula dressing and securement practices.
• Low adherence to local guidelines highlights a gap in current practice.
• Further evidence is required to develop optimal techniques and inform clinical practice guidelines.