TITLE

Superior venous drainage in the “LifeBox”: a portable extracorporeal oxygenator with a self-expanding venous cannula

AUTHOR(S)
Berdajs, Denis; Born, Frank; Crosset, Monique; Horisberger, Judith; Künzli, Andreas; Ferrari, Enrico; Tozzi, Piergiorgo; von Segesser, Ludwig K.
PUB. DATE
July 2010
SOURCE
Perfusion;Jul2010, Vol. 25 Issue 4, p211
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: In an experimental setting, the performance of the LifeBox, a new portable extracorporeal membrane oxygenator (ECMO) system suitable for patient transport, is presented. Standard rectilinear percutaneous cannulae are normally employed for this purpose, but have limited flow and pressure delivery due to their rigid structure. Therefore, we aimed to determine the potential for flow increase by using self-expanding venous cannulae. Methods: Veno-arterial bypass was established in three pigs (40.6±5.1 kg). The venous line of the cardiopulmonary bypass was established by cannulation of the external jugular vein. The arterial side of the circulation was secured by cannulation of the common carotid artery. Two different venous cannulae (SmartCanula 18/36F 430mm and Biomedicus 19F) were examined for their functional integrity when used in conjunction with the centrifugal pump (500-3000 RPM) of the LifeBox system. Results: At 1500, 2000, 2500, and 3000 RPM, the blood flow increased steadily for each cannula, but remained higher in the self-expanding cannula. That is, the 19F rectilinear cannula achieved a blood flow of 0.93±0.14, 1.47±0.37, 1.9±0.68, and 1.5±0.9 l/min, respectively, and the 18/36F self-expanding cannula achieved 1.1±0.1, 1.9±0.33, 2.8±0.39 and 3.66±0.52 l/min. However, when tested for venous line pressure, the standard venous cannula achieved -29±10.7mmHg while the self-expanding cannula achieved -13.6 ±4.3mmHg at 1500 RMP. As the RPM increased from 2500 to 3000, the venous line pressure accounted for −141.9±20 and −98±7.3mmHg for the 19F rectilinear cannula and -30.6±6.4 and -45±11.6mmHg for the self-expanding cannula. Conclusion: The self-expanding cannula exhibited superior venous drainage ability when compared to the performance of the standard rectilinear cannula with the use of the LifeBox. The flow rate achieved was approximately 40% greater than the standard drainage device, with a maximal pump flow recorded at 4.3l/min.
ACCESSION #
62030374

 

Related Articles

  • A simple method of vascular access to perform emergency coronary angiography in patients with veno-arterial extracorporeal membrane oxygenation. Endemann, Dierk; Philipp, Alois; Hengstenberg, Christian; Luchner, Andreas; Pühler, Thomas; Hilker, Michael; Schmid, Christof; Riegger, Günter; Müller, Thomas; Resch, Markus // Intensive Care Medicine;Dec2011, Vol. 37 Issue 12, p2046 

    Purpose: Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is progressively used in severe cardiogenic shock or in-hospital resuscitation to stabilize patients and to bridge to further therapeutic interventions. However, vascular access for coronary catheterization can be difficult...

  • Outcome Predictors of Pediatric Extracorporeal Cardiopulmonary Resuscitation. Kelly, Robert B.; Harrison, Rick E. // Pediatric Cardiology;Jul2010, Vol. 31 Issue 5, p626 

    Extracorporeal cardiopulmonary resuscitation (ECPR) allows clinicians to potentially rescue pediatric patients unresponsive to traditional cardiopulmonary resuscitation (CPR). Clinical and laboratory variables predictive of survival to hospital discharge are beginning to emerge. In this...

  • The science and practice of cardiopulmonary bypass: From cross circulation to ECMO and SIRS. Punjabi, Prakash P.; Taylor, K. M. // Global Cardiology Science & Practice;2013, Vol. 2013 Issue 3, p1 

    The article focuses on the science and practice of cardiopulmonary bypass (CPB), considering the cross circulation to systemic inflammatory response syndrome (SIRS) and extracorporeal membrane oxygenation (ECMO). It provides information on the history of CPB, oxygenation, the principles of...

  • Extracorporeal membrane oxygenation for refractory cardiogenic shock after cardiac surgery: predictors of early mortality and outcome from 51 adult patients Hsu, Po-Shun; Chen, Jia-Lin; Hong, Guo-Jieng; Tsai, Yi-Ting; Lin, Chih-Yuan; Lee, Chung-Yi; Chen, Yu-Guang; Tsai, Chien-Sung // European Journal of Cardio-Thoracic Surgery;Feb2010, Vol. 37 Issue 2, p328 

    Abstract: Objective: Extracorporeal membrane oxygenation (ECMO) offers temporary haemodynamic support for those with refractory cardiogenic shock after cardiac surgery. We review our 5-year experience regarding ECMO use on those who cannot be weaned from cardiopulmonary bypass after cardiac...

  • Open and closed chest extrathoracic cannulation for cardiopulmonary bypass and extracorporeal life support: methods, indications, and outcomes. Field, M. L.; Al-Alao, B.; Mediratta, N.; Sosnowski, A. // Postgraduate Medical Journal;May2006, Vol. 82 Issue 967, p323 

    Extrathoracic cannulation to establish cardiopulmonary bypass has been widely applied in recent years and includes: (a) repeat surgery, (b) minimally invasive surgery, and (c) cases with diseased vessels such as porcelain, aneurysmal, and dissecting aorta. In addition, the success and relative...

  • Extracorporeal life support. Gaffney, Alan M.; Wildhirt, Stephen M.; Griffin, Michael J.; Annich, Gail M.; Radomski, Marek W. // BMJ: British Medical Journal (Overseas & Retired Doctors Edition;11/6/2010, Vol. 341 Issue 7780, p982 

    The article offers information on extracorporeal life support (ECLS), a variation of cardiopulmonary bypass. ECLS can be undertaken either by venous-venous cannulation for isolated respiratory failure, or venous-arterial cannulation for cardiac failure with or without failure. It is said to be...

  • How to ensure a good flow to the arm during direct axillary artery cannulation Capuano, Fabio; Danesi, Tommaso Hinna; Roscitano, Antonino; Sinatra, Riccardo // European Journal of Cardio-Thoracic Surgery;Aug2011, Vol. 40 Issue 2, p520 

    Abstract: We herein describe a simple and safe technique to avoid compartment syndrome/arm ischemia during direct right axillary artery cannulation, especially in patients who require long-term extracorporeal membrane oxygenation support.

  • Reconstruction of the Carotid Artery Following Extracorporeal Membrane Oxygenation (ECMO). Armainsson, Lars T.; Ilbawi, Michel N.; Hernandez-Argudin, Gonzalo; Ostrowski, Diane; Tubeszewski, Katherine; Roberson, David A.; Ramilo, Jose L.; Sulayman, Rabi F. // Vascular Surgery;Sep/Oct1995, Vol. 29 Issue 5, p345 

    Although ligation of the carotid artery following extracorporeal membrane oxygenation (ECMO) procedures has not been associated with any apparent acute neurologic changes, its long-term sequelae on cerebral function are still unknown. The authors have adopted a policy of repairing all carotid...

  • Innominate artery aneurysm after cannulation for extracorporeal membrane oxygenation via the right carotid artery. Murthy, Srinivas; MacDonald, Cathy; Honjo, Osami; Floh, Alejandro; Humpl, Tilman // Intensive Care Medicine;Nov2013, Vol. 39 Issue 11, p2038 

    The article describes the case of a 6-year-old female who was cannulated via the right carotid onto veno-arterial extracorporeal membrane oxygenation for 6 days due to ventricular tachycardia. Two weeks after undergoing reconstruction of carotid artery dissection, the patient developed...

Share

Read the Article

Courtesy of NEW JERSEY STATE LIBRARY

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics