Venovenous Single Lumen Cannula Extracorporeal Lung Support in Neonates

Jy, Chevalier; Couprie, C; Larroquet, Michelle; Renolleau, Sylvain; Durandy, Yves; Costil, J

doi:10.1097/00002480-199307000-00103

Cited by 12 publications

(18 citation statements)

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“…To offer ECMO as an effective rescue therapy in wider application, simpler, less invasive, and therefore safer (and less expensive) techniques of ECMO may be neccessary. Single needle tidal flow ECMO seems to be such an alternative for patients eligible for venovenous ECMO ( 1, 8). This study presents for the first time laboratory data describing the efficacy of and circulatory changes induced by an easy to assemble neonatal tidal flow ECMO system operated by a centrifugal pump.…”

Section: Discussionmentioning

confidence: 99%

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A Centrifugal Pump Driven Tidal Flow Extracorporeal Membrane Oxygenation System Tested with Neonatal Mock Circulation

Trittenwein

Kölbl²,

Trittenwein

et al. 1999

Artificial Organs

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In 1993, Chevalier published his experiences with tidal flow venovenous extracorporeal membrane oxygenation (ECMO) featuring a single lumen cannula, non-occlusive roller pump, and alternating clamps. Using a neonatal mock circulation (NMC), which enables different hemodynamic states for neonatal ECMO research, the tested hypothesis was that it is possible to create a centrifugal pump driven tidal flow neonatal venovenous ECMO system. Additionally, the resulting hemodynamic effects in a condition of circulatory impairment were investigated. The ECMO circuit tested was assembled using a pediatric centrifugal pump head, a distensible reservoir, and a rotary clamp separating drainage from the injection phase. Using the NMC, end tidal volumes, mock circulation flow, and arterial and venous pressures were measured at different pump speeds after the drainage and injection phases. Effective venovenous ECMO flow (evvEF) was calculated. Mock circulation baseline values (ECMO clamped) were compared to values during tidal flow ECMO. At 3,000 rpm, a centrifugal pump speed of 75 ml/kg/min evvEF was reached, and it increased with higher pump speeds. At this point, the end tidal mock circulation flow (representing cardiac output) after drainage differed significantly from that during the injection phase (p < 0.01) but not from the baseline value. The end tidal arterial and venous pressures after the drainage phase were found to be significantly decreased compared to the baselines (p < 0.01). In conclusion, a centrifugal pump driven tidal flow venovenous ECMO system can be created enabling sufficient tidal volumes. Tested in the described NMC simulating posthypoxic circulatory impairment, significant hemodynamic effects could be demonstrated. Animal experiments for confirmation are necessary.

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Section: Discussionmentioning

confidence: 99%

“…In 1993, Chevalier published his experiences with tidal flow venovenous extracorporeal membrane oxygenation (ECMO) for neonatal lung support ( 1). The ECMO system used by his group was named the assistance respiratoire extra corporelle (AREC), featuring a single lumen venovenous ECMO cannula, a nonocclusive roller pump, and a pair of alternating clamps.…”

mentioning

confidence: 99%

A Centrifugal Pump Driven Tidal Flow Extracorporeal Membrane Oxygenation System Tested with Neonatal Mock Circulation

Trittenwein

Kölbl²,

Trittenwein

et al. 1999

Artificial Organs

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“…The AREC system has been described previously (4). Briefly, a nonocclusive roller pump drives a distensible silicone rubber raceway attached at the outside of the pump head.…”

Section: Methodsmentioning

confidence: 99%

“…Few reports on usage of different kinds of blood pumps used for neonatal and pediatric ECMO have been published (2,3). Nonocclusive roller pumps create lower pressure heads within the ECMO circuits and were described therefore to result in lower risk of raceway rupture often followed by gas embolism (4). Centrifugal pumps, mainly used as ventricular assist devices, enable easy transportation on extracorporeal circulation due to their simple technology.…”

mentioning

confidence: 99%

“…Centrifugal pumps, mainly used as ventricular assist devices, enable easy transportation on extracorporeal circulation due to their simple technology. The French assistence respiratoire extra corporelle (AREC) system, another ECMO system using a nonocclusive roller pump with a distendible raceway, enables a single needle venovenous ECMO (4). The ECMO program of the University Children's Hospital in Vienna, Austria, was established in 1993 using these 2 types of nonocclusive roller pumps.…”

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confidence: 99%

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Neonatal and Pediatric Extracorporeal Membrane Oxygenation Using Nonocclusive Blood Pumps: The Vienna Experience

et al. 2001

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Neonatal and pediatric extracorporeal membrane oxygenation (ECMO) is carried out commonly using occlusive blood pumps. Centrifugal pumps provide simple and safe technology for transportation on ECMO. The assistence respiratoire extra corporelle (AREC) system enables single needle venovenous ECMO for infants. We report on our experience with neonatal and pediatric ECMO treatments using nonocclusive blood pumps. One-hundred forty-six ECMO treatments were performed for cardiac, neonatal, and pediatric indications in 54, 19, and 27% of cases. Centrifugal pumps were used in 99, and the AREC system in 42 cases. Hospital mortality was estimated retrospectively and influence of type of pump, type of ECMO belonging to indication group, and lactate at ECMO installation were estimated. Irreversible organ failure leading to ECMO termination was investigated within groups of indications. Survival (recent 50 ECMO treatments) was 80, 70, 43, and 30% after meconium aspiration syndrome, acute respiratory distress syndrome, cardiac surgery, and prolonged resuscitation. Lactate exceeding 100 mg/dl at ECMO installation predicted significantly worse outcome. Cerebral damage was the main reason for ECMO termination in all but persistent circulatory failure in the cardiac group. Myocardial recovery resulted in all except 2 cardiac cases. Nonocclusive blood pumps can be used safely in neonatal and pediatric ECMO. Early installation may improve outcome markedly. In cardiac cases results of surgery should be thoroughly investigated on the table before ECMO installation to prevent hopeless ECMO treatments.

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Extrakorporale Membranoxygenierung (ECMO) im Erwachsenenalter

Meinhardt

Quintel

2002

Intensivmedizin und Notfallmedizin

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Venovenous Single Lumen Cannula Extracorporeal Lung Support in Neonates

Cited by 12 publications

References 0 publications

A Centrifugal Pump Driven Tidal Flow Extracorporeal Membrane Oxygenation System Tested with Neonatal Mock Circulation

A Centrifugal Pump Driven Tidal Flow Extracorporeal Membrane Oxygenation System Tested with Neonatal Mock Circulation

Neonatal and Pediatric Extracorporeal Membrane Oxygenation Using Nonocclusive Blood Pumps: The Vienna Experience

Extrakorporale Membranoxygenierung (ECMO) im Erwachsenenalter

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