Veno-Venous Extracorporeal Membrane Oxygenation (V V ECMO): Indications, Preprocedural Considerations, and Technique

Abstract

Veno-venous extracorporeal membrane oxygenation (V V ECMO) has been used for refractory respiratory failure. We describe the indications, technical aspects, and outcomes of placing V V ECMO in adults using a dual-lumen, single-cannula catheter.

Extracorporeal membrane oxygenation with multiple-organ failure: Can molecular adsorbent recirculating system therapy improve survival?

“…The only exclusion criterion was any ECMO patient in whom treatment was deemed futile within the first 24 hours of cannulation. Veno-arterial ECMO (VA ECMO) was primarily used for refractory cardiac failure, 7 and veno-veno ECMO (VV ECMO) was primarily used for refractory respiratory failure, 8 detailed in the previous publications.…”

Systemic inflammatory response syndrome (SIRS) after extracorporeal membrane oxygenation (ECMO): Incidence, risks and survivals

“…4,5 Medical records of patients who survived ECMO were reviewed, and their pre-, intra-, and post-ECMO data were entered into a structured database after approval from the institutional review board. Patients who died within 48 hours of ECMO decannulation were excluded from the study.…”

“…ECMO decannulation was performed in the operating room with direct vessel repair. 4,5 Peri-operative antibiotics were used for only 24 hours post-decannulation unless a course of antibiotics initiated during ECMO were being completed. Antibiotics were extended past 24 hours post-decannulation based on clinical judgment if a patient exhibited signs of a new infection.…”

Cannulation techniques for extracorporeal life support

“…The arterial return is directed into descending aorta via arterial cannula (15)(16)(17)(18)(19)(20)(21)(22)(23). The size of the cannula depends on calibre of the vessels and flows required to achieve adequate circulatory support.…”

“…The middle port rests in the RA and faces tricuspid valve. This port is designed to return oxygenated blood from ECMO circuit (21). The benefits of the Avalon cannula include reduction of bleeding risks since only one vessel is punctured, lower rate of recirculation, and ease of mobilisation.…”