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Successful primary use of VVDL+V ECMO with cephalic drain in neonatal respiratory failure

Journal of Perinatology volume 36, pages 126–131 (2016)Cite this article

Subjects

Abstract

Objective:

To describe the use of double-lumen venovenous (VVDL) extracorporeal membrane oxygenation (ECMO) with cephalic draining cannula (VVDL+V) as a primary approach for all neonatal respiratory diagnoses and to compare our single-center experience with data as collected in the Extracorporeal Life Support Organization (ELSO) database.

Study Design:

We retrospectively reviewed all cases of ECMO for neonatal respiratory failure performed in the neonatal intensive-care unit at a large referral children’s hospital, the Children’s Healthcare of Atlanta at Egleston (CHOA-E). Comparisons were then made to neonatal respiratory ECMO data retrieved from the ELSO database.

Results:

At CHOA-E 162 of 189 cases were completed with the VVDL+V approach. Survival in the VVDL+V cohort was 89.1% versus 68.7% from ELSO, P<0.001. For those complications considered, the overall risk of complication favored the CHOA-E VVDL+V group as compared with ELSO (odds ratio (OR) 0.71 (0.52–0.7)) as did the risk of neurologic complications (OR 0.29, (0.15–0.58)), including intracranial hemorrhage (OR 0.39 (0.18–0.97), P=0.011).

Conclusion:

The VVDL+V approach can be used successfully as the primary approach for ECMO for neonatal respiratory failure of various etiologies and in this single-center cohort this approach was associated with improved survival and lower rates of complication as compared with the ELSO database.

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Acknowledgements

All patients included in this work were cared for at the Children’s Healthcare of Atlanta at Egleston in Atlanta, GA, USA.

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Authors and Affiliations

  1. Department of Pediatrics, Emory Children’s Center, Emory University, School of Medicine, Atlanta, GA, USA

    J Roberts, S Keene, C McCracken & T W Gauthier

  2. ECMO and Advanced Technologies Department, Children’s Healthcare of Atlanta, Atlanta, GA, USA

    M Heard

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  1. J Roberts
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  2. S Keene
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  3. M Heard
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  4. C McCracken
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  5. T W Gauthier
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Correspondence to J Roberts.

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The authors declare no conflict of interest.

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Roberts, J., Keene, S., Heard, M. et al. Successful primary use of VVDL+V ECMO with cephalic drain in neonatal respiratory failure. J Perinatol 36, 126–131 (2016). https://doi.org/10.1038/jp.2015.163

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