title: Transesophageal echocardiography-guided technique for extracorporeal membrane oxygenation dual-lumen catheter placement.
abstract: In acute respiratory distress syndrome (ARDS) with severe hypoxemia or respiratory acidosis, veno-venous extracorporeal membrane oxygenation (VV-ECMO) ensures oxygenation and decarboxylation. Commonly, simultaneous cannulation of jugular and femoral veins is used for VV-ECMO. A recently introduced dual-lumen cannula for VV-ECMO promises single vessel access through the right internal jugular vein and patient ambulation. However, correct direction of the reinfusion jet toward the tricuspid valve during ECMO treatment requires more demanding cannula placement control. We present a new ultrasound-guided technique for the placement of a dual-lumen VV-ECMO cannula in a patient with ARDS and extreme obesity.
authors.affiliation: Department of Anesthesiology, University Hospital Grosshadern, Ludwig-Maximilians-University, Munich, Germany. Michael.Dolch@med.uni-muenchen.de
authors.forename: Michael E
authors.initials: ME
authors.lastname: Dolch
authors.forename: Lorenz
authors.initials: L
authors.lastname: Frey
authors.forename: Martin A
authors.initials: MA
authors.lastname: Buerkle
authors.forename: Thomas
authors.initials: T
authors.lastname: Weig
authors.forename: Dietmar
authors.initials: D
authors.lastname: Wassilowsky
authors.forename: Michael
authors.initials: M
authors.lastname: Irlbeck
mesh_terms: D057785:Catheters; D017548:Echocardiography, Transesophageal / Q000379:methods*; D004867:Equipment Design; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006801:Humans; D007601:Jugular Veins / Q000473:pathology; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000628:therapy*; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy*; D014261:Tricuspid Valve / Q000473:pathology; D014465:Ultrasonics