title: The use of cephalad cannulae to monitor jugular venous oxygen content during extracorporeal membrane oxygenation.
abstract: BACKGROUND: When used during extracorporeal membrane oxygenation (ECMO), jugular venous bulb catheters, known as cephalad cannulae, increase venous drainage, augment circuit flow and decompress cerebral venous pressure. Optimized cerebral oxygen delivery during ECMO may contribute to a reduction in neurological morbidity. This study describes the use of cephalad cannulae and identifies rudimentary data for jugular venous oxygen saturation (JVO2) and arterial to jugular venous oxygen saturation difference (AVDO2) in this patient population. RESULTS: Patients on venoarterial (VA) ECMO displayed higher JVO2 (P < 0.01) and lower AVDO2 (P = 0.01) than patients on venovenous (VV) ECMO (P < 0.01). During VV ECMO, JVO2 was higher and AVDO2 lower when systemic pH was < 7.35 rather than > 7.4 (P = 0.01). During VA ECMO, similar differences in AVDO2 but not in JVO2 were observed at different pH levels (P = 0.01). CONCLUSIONS: Jugular venous saturation and AVDO2 were influenced by systemic pH, ECMO type and patient age. These data provide the foundation for normative values of JVO2 and AVDO2 in neonates and children treated with ECMO.
authors.affiliation: Critical Care Medicine rpettign@mail.egleston.org
authors.initials: R
authors.lastname: Pettignano
authors.initials: M
authors.lastname: Labuz
authors.initials: TW
authors.lastname: Gauthier
authors.initials: J
authors.lastname: Huckaby
authors.initials: RH
authors.lastname: Clark