Safety and outcomes of mobile ECMO using a bicaval dual-stage venous catheter

Hussein D. Kanji, Alexandra Chouldechova, Chris Harvey, Ephraim O’dea, Gail Faulkner, Giles J. Peek

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

There is little published data on the safety and effectiveness of mobile (inter-hospital) extra-corporeal membrane oxygenation (ECMO) in adults, particularly focusing on the cannulation strategy. We sought to study the outcomes of patients cannulated with a bicaval dual lumen catheter needing mobile compared to conventional ECMO. Specifically, we evaluated the safety of using this cannulation strategy during initiation, in transport and overall performance. Multivariate adjustment was performed to report on adjusted 6-month survival as well as complications and performance from cannulation and the ECMO run. A total of 170 consecutive patients (44 mobile ECMO, 126 conventional ECMO) with severe hypoxemic respiratory failure were included in our cohort from 2010-2014. Improved in-hospital survival and adjusted lower 6-month mortality favored the mobile ECMO group (86% vs 79%; OR 0.24[0.07-0.69]). Performance of ECMO and complications were similar between the two groups. There were no serious ECMO cannulation related complications reported during cannulation and on transport. We conclude that the use of bicaval dual lumen catheters instituted with fluoroscopy guidance, at referral sites is safe and should be considered in mobile ECMO patients. Furthermore, mobile ECMO is associated with an unexpected mortality benefit in severely hypoxemic patients. Further prospective study is needed to elucidate this finding.

Original languageEnglish (US)
JournalASAIO Journal
DOIs
StateAccepted/In press - Dec 2 2016

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Oxygenation
Catheters
Membranes
Safety
Catheterization
Mobile Health Units
Survival
Mortality
Fluoroscopy
Respiratory Insufficiency
Referral and Consultation
Outcome Assessment (Health Care)
Prospective Studies

ASJC Scopus subject areas

  • Bioengineering
  • Biophysics
  • Medicine(all)
  • Biomaterials
  • Biomedical Engineering

Cite this

Safety and outcomes of mobile ECMO using a bicaval dual-stage venous catheter. / Kanji, Hussein D.; Chouldechova, Alexandra; Harvey, Chris; O’dea, Ephraim; Faulkner, Gail; Peek, Giles J.

In: ASAIO Journal, 02.12.2016.

Research output: Contribution to journalArticle

Kanji, Hussein D. ; Chouldechova, Alexandra ; Harvey, Chris ; O’dea, Ephraim ; Faulkner, Gail ; Peek, Giles J. / Safety and outcomes of mobile ECMO using a bicaval dual-stage venous catheter. In: ASAIO Journal. 2016.
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