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Multicenter comparison of conventional venoarterial access versus venovenous double-lumen catheter access in newborn infants undergoing extracorporeal membrane oxygenation.
J Pediatr Surg. 1993 Apr; 28(4):530-4; discussion 534-5.JP

Abstract

A multicenter trial was designed to compare standard venoarterial (VA) access versus single-catheter, venovenous access using the double-lumen catheter (VV-DLC) for newborns with respiratory failure undergoing extracorporeal membrane oxygenation (ECMO). Twenty-seven ECMO centers participated, each submitting data from the center's most recent VA cases, and data from VV-DLC cases completed upon entering the study. Data from 135 VA ECMO cases and 108 VV-DLC cases were submitted. All diagnoses resulting in neonatal respiratory failure were submitted, including patients with congenital diaphragmatic hernia (24 patients VA bypass, 11 patients VV-DLC bypass). Overall survival in patients undergoing VA bypass was 87%, while survival in patients undergoing VV-DLC bypass was 95%. Eleven patients required conversion from VV-DLC bypass to VA bypass because of insufficient support--10 of these patients survived (91% survival). Average bypass time for newborns undergoing VA bypass was 132 +/- 7.4 hours versus 100 +/- 5.1 hours for those undergoing VV-DLC bypass. Neurologic complications were more common in the VA bypass patients, although the VV patients were more stable. Hemorrhagic, cardiopulmonary, and mechanical complications, other than kinking of the DLC, occurred with approximately equal frequency in each group. In conclusion, in newborns with adequate cardiac function, venovenous ECMO using the DLC can provide the same level of support as conventional VA ECMO, without ligation of the carotid artery.

Authors+Show Affiliations

Extracorporeal Life Support Organization, Ann Arbor, MI.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study

Language

eng

PubMed ID

8483065

Citation

Anderson, H L., et al. "Multicenter Comparison of Conventional Venoarterial Access Versus Venovenous Double-lumen Catheter Access in Newborn Infants Undergoing Extracorporeal Membrane Oxygenation." Journal of Pediatric Surgery, vol. 28, no. 4, 1993, pp. 530-4; discussion 534-5.
Anderson HL, Snedecor SM, Otsu T, et al. Multicenter comparison of conventional venoarterial access versus venovenous double-lumen catheter access in newborn infants undergoing extracorporeal membrane oxygenation. J Pediatr Surg. 1993;28(4):530-4; discussion 534-5.
Anderson, H. L., Snedecor, S. M., Otsu, T., & Bartlett, R. H. (1993). Multicenter comparison of conventional venoarterial access versus venovenous double-lumen catheter access in newborn infants undergoing extracorporeal membrane oxygenation. Journal of Pediatric Surgery, 28(4), 530-4; discussion 534-5.
Anderson HL, et al. Multicenter Comparison of Conventional Venoarterial Access Versus Venovenous Double-lumen Catheter Access in Newborn Infants Undergoing Extracorporeal Membrane Oxygenation. J Pediatr Surg. 1993;28(4):530-4; discussion 534-5. PubMed PMID: 8483065.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multicenter comparison of conventional venoarterial access versus venovenous double-lumen catheter access in newborn infants undergoing extracorporeal membrane oxygenation. AU - Anderson,H L,3rd AU - Snedecor,S M, AU - Otsu,T, AU - Bartlett,R H, PY - 1993/4/1/pubmed PY - 1993/4/1/medline PY - 1993/4/1/entrez SP - 530-4; discussion 534-5 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 28 IS - 4 N2 - A multicenter trial was designed to compare standard venoarterial (VA) access versus single-catheter, venovenous access using the double-lumen catheter (VV-DLC) for newborns with respiratory failure undergoing extracorporeal membrane oxygenation (ECMO). Twenty-seven ECMO centers participated, each submitting data from the center's most recent VA cases, and data from VV-DLC cases completed upon entering the study. Data from 135 VA ECMO cases and 108 VV-DLC cases were submitted. All diagnoses resulting in neonatal respiratory failure were submitted, including patients with congenital diaphragmatic hernia (24 patients VA bypass, 11 patients VV-DLC bypass). Overall survival in patients undergoing VA bypass was 87%, while survival in patients undergoing VV-DLC bypass was 95%. Eleven patients required conversion from VV-DLC bypass to VA bypass because of insufficient support--10 of these patients survived (91% survival). Average bypass time for newborns undergoing VA bypass was 132 +/- 7.4 hours versus 100 +/- 5.1 hours for those undergoing VV-DLC bypass. Neurologic complications were more common in the VA bypass patients, although the VV patients were more stable. Hemorrhagic, cardiopulmonary, and mechanical complications, other than kinking of the DLC, occurred with approximately equal frequency in each group. In conclusion, in newborns with adequate cardiac function, venovenous ECMO using the DLC can provide the same level of support as conventional VA ECMO, without ligation of the carotid artery. SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/8483065/Multicenter_comparison_of_conventional_venoarterial_access_versus_venovenous_double_lumen_catheter_access_in_newborn_infants_undergoing_extracorporeal_membrane_oxygenation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/0022-3468(93)90611-N DB - PRIME DP - Unbound Medicine ER -