Venovenous cannulation for extracorporeal membrane oxygenation using a bicaval dual-lumen catheter in neonates

David A Lazar, Darrell L Cass, Oluyinka O Olutoye, Eugene S Kim, Stephen E Welty, Caraciolo J Fernandes, Timothy C Lee
Journal of Pediatric Surgery 2012, 47 (2): 430-4

PURPOSE: Venovenous extracorporeal membrane oxygenation (VV-ECMO) has been used as a management strategy for neonates with refractory pulmonary failure. However, VV-ECMO has been limited in neonates secondary to cannula design and patient size. Herein, we describe the use of a bicaval dual-lumen catheter for VV-ECMO in neonates.

METHODS: The medical records of all neonates cannulated for ECMO support with a bicaval dual-lumen 13F catheter from 2008 to 2010 were reviewed.

RESULTS: Nine neonates cannulated with this dual-lumen catheter were identified. The median gestational age was 38 weeks (range, 31-40 weeks), the median weight was 3.4 kg (range, 2.2-5.5 kg), the median age at cannulation was 2 days (range, 1-64 days), and the median duration of ECMO support was 7 days (range, 5-23 days). There were no VV-to-VA conversions. The median pump flow both at 4 and 24 hours postcannulation was 300 mL/min (range, 240-370 mL/min). One patient developed cannula thrombosis, and one required cannula repositioning because of flow recirculation. Overall survival was 56%.

CONCLUSION: The dual-lumen bicaval catheter can be safely used in neonates with minimal complications and is our preferred method for VV-ECMO support in the neonatal population.

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