Percutaneous cannulation for pediatric venovenous extracorporeal life support

Background/Purpose: The objective of this study was to show the safety and efficacy of a method of percutaneous cannulation for venovenous extracorporeal life support (ECLS) access in nonneonatal (>10 kg) pediatric patients. Methods: Between June 1992 and October 1998, 26 pediatric patients (age...

Full description

Saved in:
Bibliographic Details
Published in:Journal of pediatric surgery 2000-06, Vol.35 (6), p.943-947
Main Authors: Foley, David S., Swaniker, Fresca, Pranikoff, Thomas, Bartlett, Robert H., Hirschl, Ronald B.
Format: Article
Language:English
Subjects:
Adolescent
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
cannulation
Catheterization, Central Venous - methods
Catheterization, Peripheral - methods
Child
Child, Preschool
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Emergency and intensive respiratory care
Extracorporeal Circulation - methods
Extracorporeal life support
Femoral Vein
Humans
Intensive care medicine
Jugular Veins
Medical sciences
percutaneous
respiratory failure
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Background/Purpose: The objective of this study was to show the safety and efficacy of a method of percutaneous cannulation for venovenous extracorporeal life support (ECLS) access in nonneonatal (>10 kg) pediatric patients. Methods: Between June 1992 and October 1998, 26 pediatric patients (age range, 3 to 17 years; weight range, 19 to 100 kg) underwent attempted percutaneous cannulation for venovenous ECLS at our institution. Venous drainage access was attempted using a modified Seldinger technique via the right internal jugular vein (RIJ, n = 22) or right femoral vein (RFV, n = 4). Reinfusion access was attempted via the RFV (n = 19), RIJ (n = 4), or left femoral vein (n = 3). Results: The percutaneous technique was successful in 24 of 26 patients (92.3%). Maximum blood flow during ECLS was 80.1 ± 30.0 mL/kg/min, generating a postmembrane lung outlet pressure of 138 ± 54.8 mm Hg. Adequate gas exchange was achieved in all patients, and survival to discharge was 79.2%. There was no procedure-related mortality. Complications potentially related to the percutaneous technique included RIJ thrombosis (n = 1) detected after decannulation and cannula site bleeding (n = 3). Conclusion: Percutaneous access may be used safely and effectively for venovenous ECLS in pediatric patients. J Pediatr Surg 35:943-947. Copyright © 2000 by W.B. Saunders Company.
ISSN:0022-3468
1531-5037
DOI:10.1053/jpsu.2000.6933