Avalon© Bicaval Dual-Lumen Cannula for Venovenous Extracorporeal Membrane Oxygenation: Survey of Cannula Use in France
Avalon© Bicaval Dual-Lumen Cannula for Venovenous Extracorporeal Membrane Oxygenation: Survey of Cannula Use in France
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DOI：
10.1097/mat.0b013e31827db6f3
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发表时间：
2013-03-01
期刊：
影响因子：
4.2
通讯作者：
Le Tulzo, Yves
中科院分区：
文献类型：
--
作者：
Chimot, Loic;Marque, Sophie;Le Tulzo, Yves
我们在法国进行了一项关于双腔双腔导管用于体外膜氧合(ECMO)的流行病学调查。联系了使用Avalon(C)插管的每一家服务机构。从业者回答了有关其实际用法和可归因于其使用的并发症的问题。我们报告了52例插管使用的数据。主要指征为急性呼吸窘迫综合征(ARDS)，占77%。在所有需要插管的患者中，46%死亡。最大流量分别为2175±556ml/min、3207±653ml/min、3963+/-729ml/min、5490±984ml/min。外科医生放置插管的比例为52%，重症医生放置插管的比例为23%，多学科团队放置插管的比例为25%。平均置入时间为26±13分钟，置入方式有经食道心电图(TEE)(67%)、经胸超声心动图(TTE)(25%)、透视(4%)或无引导(4%)。主要并发症为右室移行。21%的病例出现溶血问题。未发现插管血栓形成病例。没有感染病例的报告。出血发生率为17%。平均使用时间为8+/-7天。在15%的病例中，需要修改支持性护理系统。监测是通过胸部X光(90%)、TTE(42%)和TEE(46%)进行的。在支助期间进行了五次拔管。9名患者被动员起来。该插管的使用取得了满意的效果。我们建议使用TTE或TEE放置这些插管，并建议低氧血症患者使用大口径插管。ASAIO Journal 2013；59：157-161。
We conducted an epidemiologic survey in France on the use of bicaval dual-lumen cannulas for extracorporeal membrane oxygenation (ECMO). Every service that used the Avalon (c) cannula was contacted. Practitioners answered questions concerning its practical usage and complications that were attributable to its usage. We report data for 52 instances of cannula usage. The primary indication was acute respiratory distress syndrome (ARDS) in 77% of cases. Of all of the patients who required cannulas, 46% died. The maximum flow was 2,175 +/- 556 ml/minute for 20-Fr.-diameter cannulas, 3,207 +/- 653 ml/minute for 23 Fr., 3,963 +/- 729 ml/minute for 27 Fr., and 5,490 +/- 984 ml/minute for 31 Fr. Surgeons placed the cannulas in 52% of cases, intensivists placed the cannulas in 23% of cases, and multidisciplinary teams placed the cannulas in 25% of cases. The mean insertion time was 26 +/- 13 minutes, and insertion was performed under transesophageal electrocardiography (TEE) (67%), transthoracic echocardiography (TTE) (25%), fluoroscopy (4%), or no guidance (4%). The main complication was migration into the right ventricle. Problems with hemolysis were described in 21% of cases. No case of cannula thrombosis was found. No case of infection was reported. Bleeding was noted in 17% of cases. The mean time of use was 8 +/- 7 days. Modifications to the supportive care system were required in 15% of cases. Monitoring was performed by chest x-rays (90%), TTE (42%), and TEE (46%). Five extubations occurred during the support period. Nine patients were mobilized. The use of this cannula yielded satisfactory results. We suggest placing these cannulas using TTE or TEE and recommend the use of large-caliber cannulas in hypoxemic patients. ASAIO Journal 2013;59:157-161.