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Venovenous extracorporeal membrane oxygenation: the effects of proximal internal jugular cannulation.
J Pediatr Surg. 1996 Oct; 31(10):1391-5.JP

Abstract

Venovenous (VV) extracorporeal membrane oxygenation (ECMO) using a double lumen catheter has become an accepted method of providing ECMO support for critically ill newborn infants. In addition, use of the cephalic jugular catheter can provide augmented venous blood flow, potentially prevent increased cerebral venous pressure, maintain cerebral venous blood flow, and increase ECMO oxygen delivery. The authors compared their experience using VV double-lumen (VVDL) ECMO with a cephalic jugular catheter with their previous experience using venoarterial (VA) ECMO. They compared 15 infants who had meconium aspiration syndrome (MAS) and 12 who had congenital diaphragmatic hernia (CDH) treated with VVDL ECMO with a cephalic jugular catheter with the same number of infants with each condition treated with VA ECMO (historical controls). There were no significant differences between the groups with respect to birth weights, oxygen indexes before ECMO, of ECMO flows at 4 and 24 hours. For infants with MAS treated with VVDL ECMO, the overall duration of ECMO support was significantly shorter (63 hours VVDLv 118 hours VA; P = .001), and the average cephalic flow was 33 mL/kg for infants treated with VVDL support. For infants with CDH, there were no differences in any of the variables evaluated, including total duration (100 hours VVDLv 128 hours VA; P = .06 [NS]), and the average cephalic flow was 39 mL/kg for infants treated with VVDL support. The venous oxygen content was significantly lower in infants with MAS treated with VVDL ECMO than for historical controls treated with VA ECMO at 4 hours of ECMO support (15.8 v 16.7; P < or = .05). No other significant differences were noted for any of the calculated oxygen transport variables comparing VVDL with VA ECMO infants with CDH treated with VVDL ECMO were extubated sooner than those treated with VA ECMO (10.3 days VVDL v 15.4 days VA; P = 048). In addition, there was no significant difference in the overall incidence of complications or death. This experience suggests that VVDL ECMO using a cephalic jugular catheter results in shorter ECMO runs and provides support that is comparable to VA ECMO for infants with CDH and MAS while avoiding carotid artery cannulation and ligation.

Authors+Show Affiliations

Department of Newborn Medicine, Royal Alexandra Hospital, Edmonton, Alberta.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8906669

Citation

Finer, N N., et al. "Venovenous Extracorporeal Membrane Oxygenation: the Effects of Proximal Internal Jugular Cannulation." Journal of Pediatric Surgery, vol. 31, no. 10, 1996, pp. 1391-5.
Finer NN, Tierney AJ, Ainsworth W. Venovenous extracorporeal membrane oxygenation: the effects of proximal internal jugular cannulation. J Pediatr Surg. 1996;31(10):1391-5.
Finer, N. N., Tierney, A. J., & Ainsworth, W. (1996). Venovenous extracorporeal membrane oxygenation: the effects of proximal internal jugular cannulation. Journal of Pediatric Surgery, 31(10), 1391-5.
Finer NN, Tierney AJ, Ainsworth W. Venovenous Extracorporeal Membrane Oxygenation: the Effects of Proximal Internal Jugular Cannulation. J Pediatr Surg. 1996;31(10):1391-5. PubMed PMID: 8906669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Venovenous extracorporeal membrane oxygenation: the effects of proximal internal jugular cannulation. AU - Finer,N N, AU - Tierney,A J, AU - Ainsworth,W, PY - 1996/10/1/pubmed PY - 1996/10/1/medline PY - 1996/10/1/entrez SP - 1391 EP - 5 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 31 IS - 10 N2 - Venovenous (VV) extracorporeal membrane oxygenation (ECMO) using a double lumen catheter has become an accepted method of providing ECMO support for critically ill newborn infants. In addition, use of the cephalic jugular catheter can provide augmented venous blood flow, potentially prevent increased cerebral venous pressure, maintain cerebral venous blood flow, and increase ECMO oxygen delivery. The authors compared their experience using VV double-lumen (VVDL) ECMO with a cephalic jugular catheter with their previous experience using venoarterial (VA) ECMO. They compared 15 infants who had meconium aspiration syndrome (MAS) and 12 who had congenital diaphragmatic hernia (CDH) treated with VVDL ECMO with a cephalic jugular catheter with the same number of infants with each condition treated with VA ECMO (historical controls). There were no significant differences between the groups with respect to birth weights, oxygen indexes before ECMO, of ECMO flows at 4 and 24 hours. For infants with MAS treated with VVDL ECMO, the overall duration of ECMO support was significantly shorter (63 hours VVDLv 118 hours VA; P = .001), and the average cephalic flow was 33 mL/kg for infants treated with VVDL support. For infants with CDH, there were no differences in any of the variables evaluated, including total duration (100 hours VVDLv 128 hours VA; P = .06 [NS]), and the average cephalic flow was 39 mL/kg for infants treated with VVDL support. The venous oxygen content was significantly lower in infants with MAS treated with VVDL ECMO than for historical controls treated with VA ECMO at 4 hours of ECMO support (15.8 v 16.7; P < or = .05). No other significant differences were noted for any of the calculated oxygen transport variables comparing VVDL with VA ECMO infants with CDH treated with VVDL ECMO were extubated sooner than those treated with VA ECMO (10.3 days VVDL v 15.4 days VA; P = 048). In addition, there was no significant difference in the overall incidence of complications or death. This experience suggests that VVDL ECMO using a cephalic jugular catheter results in shorter ECMO runs and provides support that is comparable to VA ECMO for infants with CDH and MAS while avoiding carotid artery cannulation and ligation. SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/8906669/Venovenous_extracorporeal_membrane_oxygenation:_the_effects_of_proximal_internal_jugular_cannulation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(96)90836-2 DB - PRIME DP - Unbound Medicine ER -