PMID- 30031357
OWN - NLM
STAT- MEDLINE
DCOM- 20190930
LR  - 20190930
IS  - 1557-8615 (Electronic)
IS  - 0883-9441 (Linking)
VI  - 47
DP  - 2018 Oct
TI  - A novel technique to establish hemodynamic monitoring in patients supported with 
      extracorporeal life support systems (ECLS) for cardiopulmonary resuscitation 
      (ECPR).
PG  - 219-221
LID - S0883-9441(18)30847-5 [pii]
LID - 10.1016/j.jcrc.2018.07.017 [doi]
AB  - PURPOSE: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) is 
      increasingly used to support conventional unsuccessful resuscitation and it is 
      mandatory to rapidly initiate invasive hemodynamic monitoring, as soon as ECPR 
      therapy is commenced. Commonly, this is achieved by establishing an additional 
      arterial line via the right radial artery for invasive blood pressure 
      measurement, but this can be challenging and risky on the one hand and might lead 
      to erroneous measurements on the other hand. Therefore, a faster, easier, safer 
      and more valid method for hemodynamic monitoring is pressingly needed. METHODS 
      AND RESULTS: We exemplarily describe one in four clinical cases, where 
      hemodynamic monitoring was rapidly established in an ECPR supported patient by 
      modification of the usual VA-ECMO setup: as previously described, a Y connector 
      was implemented in the arterial cannula and equipped with a hemostatic valve at 
      its blind end. Then, a 5 F pigtail catheter was introduced, pushed forward, and 
      connected with a pressure transducer. This approach allows for a rapid and safe 
      measurement of central blood pressure without need for a potentially hazardous 
      additional arterial line. CONCLUSION: Invasive hemodynamic monitoring in 
      critically ill patients with VA-ECMO support is easily and rapidly achievable by 
      introducing a pigtail catheter through a modified arterial ECMO cannula. 
      Validation of this method in larger clinical trials is warranted.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Lunz, Dirk
AU  - Lunz D
AD  - Department of Anesthesiology and Critical Care, University Hospital of 
      Regensburg, Regensburg, Germany.
FAU - Philipp, Alois
AU  - Philipp A
AD  - Department of Cardiothoracic Surgery, University Hospital of Regensburg, 
      Regensburg, Germany.
FAU - Birner, Christoph
AU  - Birner C
AD  - Department of Internal Medicine II, University Hospital of Regensburg, 
      Regensburg, Germany. Electronic address: 
      christoph.birner@klinik.uni-regensburg.de.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180717
PL  - United States
TA  - J Crit Care
JT  - Journal of critical care
JID - 8610642
SB  - IM
MH  - Cardiopulmonary Resuscitation/*methods
MH  - *Catheterization
MH  - *Extracorporeal Membrane Oxygenation/methods
MH  - Female
MH  - *Hemodynamic Monitoring
MH  - Humans
MH  - Middle Aged
MH  - Radiography, Interventional
MH  - Sepsis/*physiopathology
MH  - Streptococcal Infections/diagnosis/*physiopathology
MH  - Superinfection
MH  - Treatment Outcome
EDAT- 2018/07/22 06:00
MHDA- 2019/10/01 06:00
CRDT- 2018/07/22 06:00
PHST- 2018/06/11 00:00 [received]
PHST- 2018/07/14 00:00 [revised]
PHST- 2018/07/16 00:00 [accepted]
PHST- 2018/07/22 06:00 [pubmed]
PHST- 2019/10/01 06:00 [medline]
PHST- 2018/07/22 06:00 [entrez]
AID - S0883-9441(18)30847-5 [pii]
AID - 10.1016/j.jcrc.2018.07.017 [doi]
PST - ppublish
SO  - J Crit Care. 2018 Oct;47:219-221. doi: 10.1016/j.jcrc.2018.07.017. Epub 2018 Jul 
      17.