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Echocardiography for adult patients supported with extracorporeal membrane oxygenation.

Douflé G, Roscoe A, Billia F, Fan E - Crit Care (2015)

Bottom Line: Venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) support is increasingly being used in recent years in the adult population.Owing to the underlying disease precipitating severe respiratory or cardiac failure, echocardiography plays an important role in the management of these patients.Nevertheless, there are currently no guidelines on the use of echocardiography in the setting of ECMO support.

View Article: PubMed Central - PubMed

Affiliation: Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, M5G 2N2, Canada. ghislaine.doufle@uhn.ca.

ABSTRACT
Venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) support is increasingly being used in recent years in the adult population. Owing to the underlying disease precipitating severe respiratory or cardiac failure, echocardiography plays an important role in the management of these patients. Nevertheless, there are currently no guidelines on the use of echocardiography in the setting of ECMO support. This review describes the current state of application of echocardiography for patients supported with both VA and VV ECMO.

No MeSH data available.


Related in: MedlinePlus

Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation (VV ECMO; Avalon Elite®) and corresponding echocardiographic views. This picture depicts a bicaval dual-lumen cannula, inserted via the internal jugular vein. The drainage holes are located in the superior vena cava and inferior vena cava (IVC), and the reinjection hole is facing the tricuspid valve (TV). a Mid-esophageal bicaval view showing the cannula within the right atrium (RA) (transesophageal echocardiography). b Transthoracic subcostal view showing the cannula in the RA; the tip of the cannula is located in the IVC. The reinjection hole is visible, oriented towards the tricuspid valve. RV, right ventricle
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Fig2: Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation (VV ECMO; Avalon Elite®) and corresponding echocardiographic views. This picture depicts a bicaval dual-lumen cannula, inserted via the internal jugular vein. The drainage holes are located in the superior vena cava and inferior vena cava (IVC), and the reinjection hole is facing the tricuspid valve (TV). a Mid-esophageal bicaval view showing the cannula within the right atrium (RA) (transesophageal echocardiography). b Transthoracic subcostal view showing the cannula in the RA; the tip of the cannula is located in the IVC. The reinjection hole is visible, oriented towards the tricuspid valve. RV, right ventricle

Mentions: The Avalon Elite® (Maquet, Rastatt, Germany) bicaval dual-lumen cannula is designed to drain blood from both the IVC and SVC, and return oxygenated blood into the RA, with the flow directed towards the TV (Fig. 2). Its advantages are single site cannulation and a decreased propensity for recirculation [31]. Echocardiography provides excellent views of the appropriate position of the different portions of the cannula (Additional files 6 and 7). Correct positioning of the cannula tip in the IVC must be confirmed to avoid cannulation of one of the hepatic veins (Additional files 8, 9, and 10). The utilization of color flow Doppler can demonstrate the direction of the returned blood towards the TV, and not the IAS or into the hepatic veins (Additional files 11, 12 and 13) [32, 33].Fig. 2


Echocardiography for adult patients supported with extracorporeal membrane oxygenation.

Douflé G, Roscoe A, Billia F, Fan E - Crit Care (2015)

Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation (VV ECMO; Avalon Elite®) and corresponding echocardiographic views. This picture depicts a bicaval dual-lumen cannula, inserted via the internal jugular vein. The drainage holes are located in the superior vena cava and inferior vena cava (IVC), and the reinjection hole is facing the tricuspid valve (TV). a Mid-esophageal bicaval view showing the cannula within the right atrium (RA) (transesophageal echocardiography). b Transthoracic subcostal view showing the cannula in the RA; the tip of the cannula is located in the IVC. The reinjection hole is visible, oriented towards the tricuspid valve. RV, right ventricle
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4591622&req=5

Fig2: Bicaval dual-lumen cannula for venovenous extracorporeal membrane oxygenation (VV ECMO; Avalon Elite®) and corresponding echocardiographic views. This picture depicts a bicaval dual-lumen cannula, inserted via the internal jugular vein. The drainage holes are located in the superior vena cava and inferior vena cava (IVC), and the reinjection hole is facing the tricuspid valve (TV). a Mid-esophageal bicaval view showing the cannula within the right atrium (RA) (transesophageal echocardiography). b Transthoracic subcostal view showing the cannula in the RA; the tip of the cannula is located in the IVC. The reinjection hole is visible, oriented towards the tricuspid valve. RV, right ventricle
Mentions: The Avalon Elite® (Maquet, Rastatt, Germany) bicaval dual-lumen cannula is designed to drain blood from both the IVC and SVC, and return oxygenated blood into the RA, with the flow directed towards the TV (Fig. 2). Its advantages are single site cannulation and a decreased propensity for recirculation [31]. Echocardiography provides excellent views of the appropriate position of the different portions of the cannula (Additional files 6 and 7). Correct positioning of the cannula tip in the IVC must be confirmed to avoid cannulation of one of the hepatic veins (Additional files 8, 9, and 10). The utilization of color flow Doppler can demonstrate the direction of the returned blood towards the TV, and not the IAS or into the hepatic veins (Additional files 11, 12 and 13) [32, 33].Fig. 2

Bottom Line: Venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) support is increasingly being used in recent years in the adult population.Owing to the underlying disease precipitating severe respiratory or cardiac failure, echocardiography plays an important role in the management of these patients.Nevertheless, there are currently no guidelines on the use of echocardiography in the setting of ECMO support.

View Article: PubMed Central - PubMed

Affiliation: Interdepartmental Division of Critical Care Medicine, University of Toronto, Toronto, ON, M5G 2N2, Canada. ghislaine.doufle@uhn.ca.

ABSTRACT
Venoarterial (VA) and venovenous (VV) extracorporeal membrane oxygenation (ECMO) support is increasingly being used in recent years in the adult population. Owing to the underlying disease precipitating severe respiratory or cardiac failure, echocardiography plays an important role in the management of these patients. Nevertheless, there are currently no guidelines on the use of echocardiography in the setting of ECMO support. This review describes the current state of application of echocardiography for patients supported with both VA and VV ECMO.

No MeSH data available.


Related in: MedlinePlus