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The Edmonton experience with venovenous extracorporeal membrane oxygenation.
J Pediatr Surg. 1998 Dec; 33(12):1749-52.JP

Abstract

BACKGROUND/PURPOSE

Despite the proven effectiveness of venovenous extracorporeal membrane oxygenation (VV ECMO) in the treatment of neonates with severe respiratory failure, this technique is not widely used. The purpose of this study was to assess the authors' policy of preferred use of VV ECMO with a cephalad catheter and to compare the results with those of the Extracorporeal Life Support Organization (ELSO) Registry.

METHODS

Charts of neonatal ECMO candidates were reviewed retrospectively. Data were collected for gestational age, birth weight, and diagnosis. Severity of illness was assessed by oxygenation index, lactate levels, and inotropic requirements before cannulation. Patients were divided into three groups: venovenous (VV), venoarterial (VA), and VV to VA ECMO. A cephalad catheter was inserted in the distal part of the jugular vein.

RESULTS

Sixty-five neonates were supported with ECMO. Cannulation with a double lumen venovenous (VVDL) catheter was attempted in 63 neonates and successfully accomplished in 57. A survival rate of 86% was observed in neonates initially placed on VV ECMO. Five neonates initially placed on VV ECMO underwent conversion to VA ECMO.

CONCLUSIONS

This study showed that the authors' preferred policy of VV ECMO did not result in an increase in mortality rate based on a comparison with ELSO data. VV ECMO with a cephalad catheter provides adequate support for unstable neonates with respiratory failure.

Authors+Show Affiliations

Royal Alexandra Hospital, Department of Pediatrics, University of Alberta, Edmonton, Canada.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9869043

Citation

Osiovich, H C., et al. "The Edmonton Experience With Venovenous Extracorporeal Membrane Oxygenation." Journal of Pediatric Surgery, vol. 33, no. 12, 1998, pp. 1749-52.
Osiovich HC, Peliowski A, Ainsworth W, et al. The Edmonton experience with venovenous extracorporeal membrane oxygenation. J Pediatr Surg. 1998;33(12):1749-52.
Osiovich, H. C., Peliowski, A., Ainsworth, W., & Etches, P. C. (1998). The Edmonton experience with venovenous extracorporeal membrane oxygenation. Journal of Pediatric Surgery, 33(12), 1749-52.
Osiovich HC, et al. The Edmonton Experience With Venovenous Extracorporeal Membrane Oxygenation. J Pediatr Surg. 1998;33(12):1749-52. PubMed PMID: 9869043.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Edmonton experience with venovenous extracorporeal membrane oxygenation. AU - Osiovich,H C, AU - Peliowski,A, AU - Ainsworth,W, AU - Etches,P C, PY - 1998/12/30/pubmed PY - 1998/12/30/medline PY - 1998/12/30/entrez SP - 1749 EP - 52 JF - Journal of pediatric surgery JO - J Pediatr Surg VL - 33 IS - 12 N2 - BACKGROUND/PURPOSE: Despite the proven effectiveness of venovenous extracorporeal membrane oxygenation (VV ECMO) in the treatment of neonates with severe respiratory failure, this technique is not widely used. The purpose of this study was to assess the authors' policy of preferred use of VV ECMO with a cephalad catheter and to compare the results with those of the Extracorporeal Life Support Organization (ELSO) Registry. METHODS: Charts of neonatal ECMO candidates were reviewed retrospectively. Data were collected for gestational age, birth weight, and diagnosis. Severity of illness was assessed by oxygenation index, lactate levels, and inotropic requirements before cannulation. Patients were divided into three groups: venovenous (VV), venoarterial (VA), and VV to VA ECMO. A cephalad catheter was inserted in the distal part of the jugular vein. RESULTS: Sixty-five neonates were supported with ECMO. Cannulation with a double lumen venovenous (VVDL) catheter was attempted in 63 neonates and successfully accomplished in 57. A survival rate of 86% was observed in neonates initially placed on VV ECMO. Five neonates initially placed on VV ECMO underwent conversion to VA ECMO. CONCLUSIONS: This study showed that the authors' preferred policy of VV ECMO did not result in an increase in mortality rate based on a comparison with ELSO data. VV ECMO with a cephalad catheter provides adequate support for unstable neonates with respiratory failure. SN - 0022-3468 UR - https://www.unboundmedicine.com/medline/citation/9869043/The_Edmonton_experience_with_venovenous_extracorporeal_membrane_oxygenation_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-3468(98)90277-9 DB - PRIME DP - Unbound Medicine ER -