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How to Do It: A Safe Bedside Protocol for Dual-Lumen Right Internal Jugular Cannulation for Venovenous Extracorporeal Membrane Oxygenation in COVID-19 Patients with Severe Acute Respiratory Distress Syndrome.
Cha, Stephanie; Kim, Bo S; Ha, Jinny S; Bush, Errol L.
  • Cha S; From the Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
  • Kim BS; Department of Pulmonary Critical Care Medicine, Johns Hopkins University, Baltimore, Maryland.
  • Ha JS; Department of Surgery, Johns Hopkins University, Baltimore, Maryland.
  • Bush EL; Department of Surgery, Johns Hopkins University, Baltimore, Maryland.
ASAIO J ; 2022 Aug 03.
Article in English | MEDLINE | ID: covidwho-2228677
ABSTRACT
In appropriately selected patients with COVID-19 acute respiratory distress syndrome, venovenous extracorporeal membrane oxygenation (VV ECMO) may offer a promising bridge to lung recovery or lung transplantation if lung recovery fails. Although the cannulation technique for VV ECMO via a right internal jugular (RIJ) dual-lumen catheter (DLC) requires expertise and guidance by either fluoroscopy or transesophageal echocardiography (TEE), it offers theoretical circulatory support advantages by using bicaval venous drainage to deliver oxygenated blood systemically with minimal recirculation as compared with the femoral vein and RIJ dual-site cannula configuration. In addition, patients are often too unstable to transport safely to an operating room or catheterization laboratory, and fluoroscopy is not always readily available to guide RIJ DLC placement. Here, we provide a comprehensive description of a safe, bedside protocol for VV ECMO cannulation via a RIJ DLC under TEE guidance. We will report our center's experience (March 30, 2020 to November 21, 2021) and discuss important hemodynamic, safety, and infection control considerations.

Full text: Available Collection: International databases Database: MEDLINE Language: English Journal subject: Transplantation Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Language: English Journal subject: Transplantation Year: 2022 Document Type: Article