PMID- 30601181
OWN - NLM
STAT- MEDLINE
DCOM- 20200908
LR  - 20210125
IS  - 1538-943X (Electronic)
IS  - 1058-2916 (Linking)
VI  - 66
IP  - 1
DP  - 2020 Jan
TI  - Semiquantification of Systemic Venous Admixture During Venovenous Extracorporeal 
      Oxygenation Via Bicaval Double-Lumen Cannula in Critically Ill Patients.
PG  - 23-31
LID - 10.1097/MAT.0000000000000943 [doi]
AB  - Venovenous extracorporeal membrane oxygenation (VV-ECMO) is increasingly utilized 
      in acute reversible cases of severe respiratory failure and as a bridge to lung 
      transplantation. Venovenous extracorporeal membrane oxygenation using a bicaval 
      double-lumen cannula (BCDLC) has several advantages over the traditional ECMO 
      configuration; however, it also presents with several unique challenges. The 
      assessment and quantification of venous admixture is difficult due to the 
      specific position of BCDLC within the circulatory system. We describe the nature 
      of the double-lumen bicaval venovenous ECMO cannula and relevant specific issues 
      associated with monitoring complex details of oxygenation within different parts 
      of circulation, including existing barriers for quantification of recirculation 
      and venous admix. New conceptual approach to the quantification of venous admix 
      is described. Right side echocardiographic contrast, when sequentially injected 
      in separate superior vena cava (SVC) and inferior vena cava (IVC) venous basins, 
      bypasses drainage ports of the catheter in double-lumen bicaval VV-ECMO 
      configuration together with deoxygenated returning from the periphery venous 
      blood. It was easily detectable entering right heart chambers by two- and 
      three-dimensional echocardiography. Amount of bubbles from the agitated fluid 
      contrast within right atrium indicates relative amount of venous admixture in 
      relation to the returning from the oxygenator blood which is bubble free.
FAU - Yastrebov, Konstantin
AU  - Yastrebov K
AD  - From the Department of Intensive Care, St George Hospital, Kogarah, University of 
      NewSouth Wales, New South Wales, Sydney, Australia.
FAU - Kapalli, Tejo
AU  - Kapalli T
AD  - From the Department of Intensive Care, St George Hospital, Kogarah, University of 
      NewSouth Wales, New South Wales, Sydney, Australia.
FAU - Manganas, Con
AU  - Manganas C
AD  - Department of Cardiothoracic Surgery, St George Hospital, Kogarah, University of 
      New South Wales, New South Wales, Sydney, Australia.
AD  - Graduate School of Medicine, University of Wollongong, Wollongong, New South 
      Wales, Australia.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - ASAIO J
JT  - ASAIO journal (American Society for Artificial Internal Organs : 1992)
JID - 9204109
RN  - S88TT14065 (Oxygen)
SB  - IM
MH  - *Cannula
MH  - *Cardiac Output
MH  - Critical Illness
MH  - Extracorporeal Membrane Oxygenation/*instrumentation/methods
MH  - Humans
MH  - Male
MH  - Oxygen/*blood
EDAT- 2019/01/03 06:00
MHDA- 2020/09/09 06:00
CRDT- 2019/01/03 06:00
PHST- 2019/01/03 06:00 [pubmed]
PHST- 2020/09/09 06:00 [medline]
PHST- 2019/01/03 06:00 [entrez]
AID - 00002480-202001000-00005 [pii]
AID - 10.1097/MAT.0000000000000943 [doi]
PST - ppublish
SO  - ASAIO J. 2020 Jan;66(1):23-31. doi: 10.1097/MAT.0000000000000943.