Venovenous compares favorably with venoarterial access for extracorporeal membrane oxygenation in neonatal respiratory failure

New Trends in Extracorporeal Membrane Oxygenation in Newborn Pulmonary Diseases

“…Newer circuits are available that decrease clot formation and the need for excessive anticoagulation. Additional advances in ECMO therapy include the use of double‐lumen VV catheters, which have been shown to have comparable results with the VA technique even in some children with circulatory compromise (i.e., CDH) (32,33). In addition, minimally invasive techniques via percutaneous methods and cannulas, which have been available for use in older children and adults, have become available in newborns.…”

A Review of Venovenous and Venoarterial Extracorporeal Membrane Oxygenation in Neonates and Children

“…Comparison of MAS patients requiring both dopamine and epinephrine infusions treated with VA and VV ECMO found no diff erence in support requirements, but a statistically signifi cant shorter duration of ECMO run time was seen in the VV group [12] . Others have reported shorter run times for VV ECMO compared to VA ECMO in patients with MAS [9] . The largest comparative series to date analyzed 114 MAS patients treated with VV ECMO and 12 with VA ECMO [22] .…”

Acute lung injury: Clinical data

“…One may consider that a "uniforming" of differently conditioned compartments can be achieved. It therefore can be assumed that PEEPi contributes to the improvement of alveolar recruitment and ventilation in patients with ARDS (16,17).…”

“…Today favorable effects are reported from ventilatory techniques supporting spontaneous breathing. It is shown by radiographic studies that a significant improvement of the distribution of the inspiratory gas flow is achieved during spontaneous breathing in comparison to mechanical ventilation (17). Caused by the predominantly dorsal movement of the diaphragm, inspiratory flow is better directed to well-perfused dependent lung regions during spontaneous breathing than during complete mechanical ventilatory support with immobilized diaphragm.…”

“…The disadvantage of the venoarterial system is the positioning of a cannula in a large arterial blood vessel and the resulting potential complications: ischemia, reperfusion, bleeding, ligation of the carotid artery, reduction of pulmonary blood flow, embolism, increased cardiac afterload, and reduction of cardiac output (15,16). Today the most common technique is percutaneous venovenous placement of the cannulas by the Seldinger technique, using the internal jugular and femoral veins (17). The femoral cannula is positioned in the inferior vena cava under the diaphragm and the jugular cannula proximal to the right atrium.…”