Pulmonary artery cannulation during venovenous extracorporeal membrane oxygenation: An alternative to manage refractory hypoxemia and right ventricular dysfunction

Rojas‐Velasco, Gustavo; Carmona-Levario, Patricia; Manzur‐Sandoval, Daniel; Lazcano-Díaz, Emmanuel Adrián; Santos, F.

doi:10.1016/j.rmcr.2022.101704

Cited by 2 publications

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References 11 publications

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“…Changing the configuration of the extracorporeal therapy by placing the return cannula toward the pulmonary artery (PA) can improve the patient's clinical condition for two main reasons: 1) by injecting oxygenated blood directly into the PA, the degree of recirculation is significantly reduced, thereby improving the systemic oxygenation of the patient; and 2) mechanical right ventricular unloading allows the application of lung and right ventricular protective ventilation [4]. This therapy could be particularly attractive in the management of patients with congenital heart disease and/or Eissenmenger syndrome, since its decompensation usually includes severe right heart failure, pulmonary hypertensive crisis, and worsening hypoxemia, as a "bridge to recovery".…”

Section: Introductionmentioning

confidence: 99%

Venopulmonary ECMO Improved Hypoxemia and Supported the Right Ventricle in a Patient with Decompensated Eisenmenger Syndrome

Manzur-Sandoval,

Jiménez-Rodríguez,

García-Cruz

et al. 2024

WJCS

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Mechanical circulatory and/or respiratory assistance with extracorporeal membrane oxygenation (ECMO) has become a standard of care for patients with circulatory (venoarterial) and/or respiratory (venovenous) failure refractory to standard therapies. Adult patients with congenital heart disease are an increasingly recognized and growing population and include various groups, such as undiagnosed cases in childhood and palliated and/or corrected cases, which require subsequent care because of residual lesions, cardiac arrest/insufficiency, and arrhythmias, among other conditions. In addition, these patients are prone to developing pathologies that are typical of adulthood with a generally increased risk of morbidity and mortality because of their low reserves and organic damage associated with the underlying heart disease, which makes them candidates for ECMO. These patients represent an additional challenge in this therapy because malformations and the presence of a shunt can generally affect the usual cannulation methods and hemodynamic and oximetry monitoring. Thus, the configuration decision must be made on a case-by-case basis. Here, we present a cannulation method, venopulmonary artery ECMO, which provides hemodynamic and respiratory support, and may be ideal for patients with shunts and/or right ventricular dysfunction. To our knowledge, this is the first report of this configuration in patients with congenital heart diseases.

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Section: Introductionmentioning

confidence: 99%