Contrast Transthoracic Echocardiography and the Placement of a Bicaval Dual‐Lumen Catheter in a Swine Model of Venovenous Extracorporeal Membrane Oxygenation

Abstract

Placement of a bicaval dual-lumen (BCDL) catheter demands sophisticated visualization in patients to assure proper positioning in order to administer single-site venovenous extracorporeal membrane oxygenation (VV ECMO). Large animal models are needed and thus appropriate procedures to assure anatomic and functional cannula placement would assist in experimental design and procedures. This report describes the use of agitated blood and saline transthoracic contrast echocardiography to confirm appropriate placement and function of the BCDL catheter in a swine model of VV ECMO. Five consecutive common crossbred piglets had confirmation using this technique with assurances of cannulation while not significantly altering experimental time and procedures. Researchers studying VV ECMO in large animal models may want to consider this method of confirmation of BCDL catheter placement.

Four hours of veno-venous extracorporeal membrane oxygenation using bi-caval cannulation affects kidney function and induces moderate lung damage in a mouse model

“…As there are no small animal models available, we could not compare these findings. Large animal ECMO models, however, showed similar oxygenation results and comparable hemodynamics but did not report renal or hepatic function parameters [15,16]. In conclusion, we present the proof-of-concept use of bi-caval double lumen ECMO in a murine model.…”

“…Animal models of bi-caval ECMO are rare, with to date, only two swine models being described [15,16]. To our knowledge, no papers on bi-caval double lumen ECMO in a murine model have been published, making this a novel model.…”

Use of Image Guidance During Pediatric Venovenous Extracorporeal Membrane Oxygenation Cannulation: A Survey of the American Pediatric Surgical Association

“…However, TTE, in particular, can be limited by poor acoustic windows, it only allows visualization of the wire in one location, and it does not permit visualization of a large portion of the IVC. For those reasons, many groups, especially those that advocate for use of echocardiography during initial wire placement or as a single modality, advocate for the use of TEE 4,8,19,30,32 or both TTE and TEE, 15,18 which can be complimentary. In our study, few surgeons incorporated TEE into their practice, likely because of decreased availability and the unique skillsets required to perform TEE.…”

Transthoracic Echocardiography of the Neonatal Laboratory Piglet

“…Lin et al performed transthoracic echocardiography in Yorkshire piglets weighing 14.3 ± 4.1 kg in a study looking at the treatment of cardiac arrest and used short axis view and M-mode (23). Common crossbred piglets between 4 and 6 weeks of age and weighing 9.2 ±1.8 kg were used by Hayes et al to visualize microbubbles (24). 3D Real-Time echocardiography was done by Herberg et al in landrace piglets with a weight range about 3.6–8.0 kg (25).…”