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The Edmonton experience with venovenous extracorporeal membrane oxygenation
H C Osiovich1, A Peliowski, W Ainsworth
1Royal Alexandra Hospital, Department of Pediatrics, University of Alberta, Edmonton, Canada.
Journal of Pediatric Surgery
|December 30, 1998
Summary
Venovenous extracorporeal membrane oxygenation (VV ECMO) with a cephalad catheter is a safe and effective treatment for neonatal respiratory failure. This approach did not increase mortality rates compared to existing data.
Area of Science:
- Neonatal Medicine
- Pediatric Critical Care
- Cardiopulmonary Support
Background:
- Severe respiratory failure in neonates poses significant challenges.
- Venovenous extracorporeal membrane oxygenation (VV ECMO) is effective but underutilized.
- Established protocols for VV ECMO in neonates are lacking.
Purpose of the Study:
- To evaluate a specific policy of using VV ECMO with a cephalad catheter in neonates.
- To compare outcomes with the Extracorporeal Life Support Organization (ELSO) Registry data.
- To assess the safety and efficacy of this VV ECMO approach.
Main Methods:
- Retrospective chart review of neonatal ECMO candidates.
- Data collection included demographics, diagnosis, and pre-cannulation severity markers.
- Patients categorized into VV, VA, and VV-to-VA ECMO groups; cephalad catheter placement detailed.
Main Results:
- 65 neonates received ECMO support; 57 successfully cannulated with a double lumen VV catheter.
- Initial VV ECMO demonstrated an 86% survival rate.
- Five neonates required conversion from VV to VA ECMO.
Conclusions:
- The authors' VV ECMO policy with a cephalad catheter did not increase mortality compared to ELSO data.
- This technique provides adequate support for neonates with respiratory failure.
- VV ECMO with a cephalad catheter is a viable option for neonatal respiratory support.