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Comparison of the Avalon Dual-Lumen Cannula with Conventional Cannulation Technique for Venovenous Extracorporeal Membrane Oxygenation.

Identifieur interne : 000189 ( Main/Exploration ); précédent : 000188; suivant : 000190

Comparison of the Avalon Dual-Lumen Cannula with Conventional Cannulation Technique for Venovenous Extracorporeal Membrane Oxygenation.

Auteurs : Thomas Kuhl [Allemagne] ; Guido Michels [Allemagne] ; Roman Pfister [Allemagne] ; Stefanie Wendt [Allemagne] ; Georg Langebartels [Allemagne] ; Thorsten Wahlers [Allemagne]

Source :

RBID : pubmed:25959306

Descripteurs français

English descriptors

Abstract

BACKGROUND

Comparison of two kinds of cannulation (double-lumen cannula [DLC, Avalon Elite Bicaval Dual Lumen Catheter] and conventional cannulation with two cannulas) for venovenous extracorporeal membrane oxygenation (ECMO) therapy in terms of effectiveness, usage complexity, and costs.

METHODS

Retrospective case series of 17 patients who received venovenous ECMO therapy due to acute respiratory distress syndrome (ARDS) between January 2010 and March 2012. Nine patients were treated with the DLC and eight patients with conventional cannulation. We analyzed the outcome data, ECMO values, respirator settings, blood gas values, realized prone positioning, and costs, and compared both methods.

RESULTS

Both kinds of cannulation are efficient regarding oxygenation and decarboxylation. There is no significant difference in mortality, hospitalization time (intensive care unit [ICU] and hospital) and complications during ECMO therapy between both groups. Cannula implantation is much more complex in the DLC group and requires more experience in TEE (transesophageal echocardiography) diagnostics and cannulation technique. In addition, the costs for the Avalon (MAQUET Cardiopulmonary AG, Germany) cannula are significantly higher than for conventional cannulation. Furthermore, prone positioning could be easier achieved in the DLC group.

CONCLUSION

In summary, double-lumen cannulation allows sufficient gas exchange with more effort (material, technical, and physicians' experience) and higher costs but better mobilization possibilities (particularly prone position) and potential avoidance of deep sedation and mechanical ventilation. From the current point of view, the DLC should be reserved for special cases.


DOI: 10.1055/s-0035-1549359
PubMed: 25959306


Affiliations:


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Le document en format XML

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<term>Adult (MeSH)</term>
<term>Aged (MeSH)</term>
<term>Blood Gas Analysis (MeSH)</term>
<term>Catheterization, Central Venous (adverse effects)</term>
<term>Catheterization, Central Venous (economics)</term>
<term>Catheterization, Central Venous (instrumentation)</term>
<term>Catheterization, Central Venous (methods)</term>
<term>Catheterization, Central Venous (mortality)</term>
<term>Catheterization, Peripheral (adverse effects)</term>
<term>Catheterization, Peripheral (economics)</term>
<term>Catheterization, Peripheral (instrumentation)</term>
<term>Catheterization, Peripheral (methods)</term>
<term>Catheterization, Peripheral (mortality)</term>
<term>Clinical Competence (MeSH)</term>
<term>Echocardiography, Transesophageal (MeSH)</term>
<term>Equipment Design (MeSH)</term>
<term>Extracorporeal Membrane Oxygenation (adverse effects)</term>
<term>Extracorporeal Membrane Oxygenation (economics)</term>
<term>Extracorporeal Membrane Oxygenation (instrumentation)</term>
<term>Extracorporeal Membrane Oxygenation (methods)</term>
<term>Extracorporeal Membrane Oxygenation (mortality)</term>
<term>Female (MeSH)</term>
<term>Health Care Costs (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Length of Stay (MeSH)</term>
<term>Male (MeSH)</term>
<term>Middle Aged (MeSH)</term>
<term>Patient Positioning (MeSH)</term>
<term>Patient Selection (MeSH)</term>
<term>Prone Position (MeSH)</term>
<term>Respiratory Distress Syndrome, Adult (diagnosis)</term>
<term>Respiratory Distress Syndrome, Adult (economics)</term>
<term>Respiratory Distress Syndrome, Adult (mortality)</term>
<term>Respiratory Distress Syndrome, Adult (physiopathology)</term>
<term>Respiratory Distress Syndrome, Adult (therapy)</term>
<term>Retrospective Studies (MeSH)</term>
<term>Risk Factors (MeSH)</term>
<term>Time Factors (MeSH)</term>
<term>Treatment Outcome (MeSH)</term>
<term>Vascular Access Devices (MeSH)</term>
<term>Young Adult (MeSH)</term>
</keywords>
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<term>Adulte (MeSH)</term>
<term>Adulte d'âge moyen (MeSH)</term>
<term>Cathétérisme périphérique (effets indésirables)</term>
<term>Cathétérisme périphérique (instrumentation)</term>
<term>Cathétérisme périphérique (mortalité)</term>
<term>Cathétérisme périphérique (méthodes)</term>
<term>Cathétérisme périphérique (économie)</term>
<term>Cathétérisme veineux central (effets indésirables)</term>
<term>Cathétérisme veineux central (instrumentation)</term>
<term>Cathétérisme veineux central (mortalité)</term>
<term>Cathétérisme veineux central (méthodes)</term>
<term>Cathétérisme veineux central (économie)</term>
<term>Compétence clinique (MeSH)</term>
<term>Conception d'appareillage (MeSH)</term>
<term>Coûts des soins de santé (MeSH)</term>
<term>Dispositifs d'accès vasculaires (MeSH)</term>
<term>Durée du séjour (MeSH)</term>
<term>Décubitus ventral (MeSH)</term>
<term>Facteurs de risque (MeSH)</term>
<term>Facteurs temps (MeSH)</term>
<term>Femelle (MeSH)</term>
<term>Gazométrie sanguine (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Jeune adulte (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (effets indésirables)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (instrumentation)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (mortalité)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (méthodes)</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane (économie)</term>
<term>Positionnement du patient (MeSH)</term>
<term>Résultat thérapeutique (MeSH)</term>
<term>Sujet âgé (MeSH)</term>
<term>Syndrome de détresse respiratoire de l'adulte (diagnostic)</term>
<term>Syndrome de détresse respiratoire de l'adulte (mortalité)</term>
<term>Syndrome de détresse respiratoire de l'adulte (physiopathologie)</term>
<term>Syndrome de détresse respiratoire de l'adulte (thérapie)</term>
<term>Syndrome de détresse respiratoire de l'adulte (économie)</term>
<term>Sélection de patients (MeSH)</term>
<term>Échocardiographie transoesophagienne (MeSH)</term>
<term>Études rétrospectives (MeSH)</term>
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<term>Catheterization, Central Venous</term>
<term>Catheterization, Peripheral</term>
<term>Extracorporeal Membrane Oxygenation</term>
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<term>Syndrome de détresse respiratoire de l'adulte</term>
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<term>Catheterization, Central Venous</term>
<term>Catheterization, Peripheral</term>
<term>Extracorporeal Membrane Oxygenation</term>
<term>Respiratory Distress Syndrome, Adult</term>
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<term>Cathétérisme périphérique</term>
<term>Cathétérisme veineux central</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
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<keywords scheme="MESH" qualifier="instrumentation" xml:lang="en">
<term>Catheterization, Central Venous</term>
<term>Catheterization, Peripheral</term>
<term>Extracorporeal Membrane Oxygenation</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en">
<term>Catheterization, Central Venous</term>
<term>Catheterization, Peripheral</term>
<term>Extracorporeal Membrane Oxygenation</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en">
<term>Catheterization, Central Venous</term>
<term>Catheterization, Peripheral</term>
<term>Extracorporeal Membrane Oxygenation</term>
<term>Respiratory Distress Syndrome, Adult</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr">
<term>Cathétérisme périphérique</term>
<term>Cathétérisme veineux central</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
<term>Syndrome de détresse respiratoire de l'adulte</term>
</keywords>
<keywords scheme="MESH" qualifier="méthodes" xml:lang="fr">
<term>Cathétérisme périphérique</term>
<term>Cathétérisme veineux central</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathologie" xml:lang="fr">
<term>Syndrome de détresse respiratoire de l'adulte</term>
</keywords>
<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en">
<term>Respiratory Distress Syndrome, Adult</term>
</keywords>
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<term>Respiratory Distress Syndrome, Adult</term>
</keywords>
<keywords scheme="MESH" qualifier="thérapie" xml:lang="fr">
<term>Syndrome de détresse respiratoire de l'adulte</term>
</keywords>
<keywords scheme="MESH" qualifier="économie" xml:lang="fr">
<term>Cathétérisme périphérique</term>
<term>Cathétérisme veineux central</term>
<term>Oxygénation extracorporelle sur oxygénateur à membrane</term>
<term>Syndrome de détresse respiratoire de l'adulte</term>
</keywords>
<keywords scheme="MESH" xml:lang="en">
<term>Adult</term>
<term>Aged</term>
<term>Blood Gas Analysis</term>
<term>Clinical Competence</term>
<term>Echocardiography, Transesophageal</term>
<term>Equipment Design</term>
<term>Female</term>
<term>Health Care Costs</term>
<term>Humans</term>
<term>Length of Stay</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Patient Positioning</term>
<term>Patient Selection</term>
<term>Prone Position</term>
<term>Retrospective Studies</term>
<term>Risk Factors</term>
<term>Time Factors</term>
<term>Treatment Outcome</term>
<term>Vascular Access Devices</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr">
<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Compétence clinique</term>
<term>Conception d'appareillage</term>
<term>Coûts des soins de santé</term>
<term>Dispositifs d'accès vasculaires</term>
<term>Durée du séjour</term>
<term>Décubitus ventral</term>
<term>Facteurs de risque</term>
<term>Facteurs temps</term>
<term>Femelle</term>
<term>Gazométrie sanguine</term>
<term>Humains</term>
<term>Jeune adulte</term>
<term>Mâle</term>
<term>Positionnement du patient</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sélection de patients</term>
<term>Échocardiographie transoesophagienne</term>
<term>Études rétrospectives</term>
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<front>
<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>Comparison of two kinds of cannulation (double-lumen cannula [DLC, Avalon Elite Bicaval Dual Lumen Catheter] and conventional cannulation with two cannulas) for venovenous extracorporeal membrane oxygenation (ECMO) therapy in terms of effectiveness, usage complexity, and costs.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>METHODS</b>
</p>
<p>Retrospective case series of 17 patients who received venovenous ECMO therapy due to acute respiratory distress syndrome (ARDS) between January 2010 and March 2012. Nine patients were treated with the DLC and eight patients with conventional cannulation. We analyzed the outcome data, ECMO values, respirator settings, blood gas values, realized prone positioning, and costs, and compared both methods.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>RESULTS</b>
</p>
<p>Both kinds of cannulation are efficient regarding oxygenation and decarboxylation. There is no significant difference in mortality, hospitalization time (intensive care unit [ICU] and hospital) and complications during ECMO therapy between both groups. Cannula implantation is much more complex in the DLC group and requires more experience in TEE (transesophageal echocardiography) diagnostics and cannulation technique. In addition, the costs for the Avalon (MAQUET Cardiopulmonary AG, Germany) cannula are significantly higher than for conventional cannulation. Furthermore, prone positioning could be easier achieved in the DLC group.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>In summary, double-lumen cannulation allows sufficient gas exchange with more effort (material, technical, and physicians' experience) and higher costs but better mobilization possibilities (particularly prone position) and potential avoidance of deep sedation and mechanical ventilation. From the current point of view, the DLC should be reserved for special cases.</p>
</div>
</front>
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<Day>21</Day>
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<Day>05</Day>
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<ISSN IssnType="Electronic">1439-1902</ISSN>
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<Issue>8</Issue>
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<Year>2015</Year>
<Month>Dec</Month>
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<AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Comparison of two kinds of cannulation (double-lumen cannula [DLC, Avalon Elite Bicaval Dual Lumen Catheter] and conventional cannulation with two cannulas) for venovenous extracorporeal membrane oxygenation (ECMO) therapy in terms of effectiveness, usage complexity, and costs.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Retrospective case series of 17 patients who received venovenous ECMO therapy due to acute respiratory distress syndrome (ARDS) between January 2010 and March 2012. Nine patients were treated with the DLC and eight patients with conventional cannulation. We analyzed the outcome data, ECMO values, respirator settings, blood gas values, realized prone positioning, and costs, and compared both methods.</AbstractText>
<AbstractText Label="RESULTS" NlmCategory="RESULTS">Both kinds of cannulation are efficient regarding oxygenation and decarboxylation. There is no significant difference in mortality, hospitalization time (intensive care unit [ICU] and hospital) and complications during ECMO therapy between both groups. Cannula implantation is much more complex in the DLC group and requires more experience in TEE (transesophageal echocardiography) diagnostics and cannulation technique. In addition, the costs for the Avalon (MAQUET Cardiopulmonary AG, Germany) cannula are significantly higher than for conventional cannulation. Furthermore, prone positioning could be easier achieved in the DLC group.</AbstractText>
<AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">In summary, double-lumen cannulation allows sufficient gas exchange with more effort (material, technical, and physicians' experience) and higher costs but better mobilization possibilities (particularly prone position) and potential avoidance of deep sedation and mechanical ventilation. From the current point of view, the DLC should be reserved for special cases.</AbstractText>
<CopyrightInformation>Georg Thieme Verlag KG Stuttgart · New York.</CopyrightInformation>
</Abstract>
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<LastName>Kuhl</LastName>
<ForeName>Thomas</ForeName>
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<Affiliation>Department of Cardiothoracic Surgery, University Cologne, Heartcenter, Cologne, Germany.</Affiliation>
</AffiliationInfo>
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<ForeName>Georg</ForeName>
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</AffiliationInfo>
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<Affiliation>Department of Cardiothoracic Surgery, University Cologne, Heartcenter, Cologne, Germany.</Affiliation>
</AffiliationInfo>
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<Language>eng</Language>
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<ArticleDate DateType="Electronic">
<Year>2015</Year>
<Month>05</Month>
<Day>06</Day>
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<Country>Germany</Country>
<MedlineTA>Thorac Cardiovasc Surg</MedlineTA>
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