title: Insertion of bicaval dual-lumen cannula via the left internal jugular vein for extracorporeal membrane oxygenation.
abstract: Venovenous extracorporeal membrane oxygenation (ECMO) can support gas exchange in patients with primary respiratory failure. Venovenous ECMO can be initiated through a single-site, dual-lumen cannula designed for insertion in the right internal jugular vein. We describe four cases of hypercapnic or hypoxemic respiratory failure, in which we performed single-site cannulation of the left internal jugular vein with 23 Fr or 27 Fr bicaval dual-lumen catheters when the right internal jugular vein was inaccessible because of either stenosis or thrombosis. The surgical approach for left-sided access is similar to the approach used for the right internal jugular vein. The left-sided approach resulted in equivalent blood flow and gas exchange compared with our previous experience with right-sided cannulation. This case series demonstrates the feasibility of placing a bicaval dual-lumen catheter in the left internal jugular vein for the initiation of venovenous ECMO when the right internal jugular vein is inaccessible.
authors.affiliation: Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Columbia University Medical Center, New York-Presbyterian Hospital, New York City, New York 10032, USA.
authors.forename: Darryl
authors.initials: D
authors.lastname: Abrams
authors.forename: Daniel
authors.initials: D
authors.lastname: Brodie
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Javidfar
authors.forename: Keith
authors.initials: K
authors.lastname: Brenner
authors.forename: Dongfang
authors.initials: D
authors.lastname: Wang
authors.forename: Joseph
authors.initials: J
authors.lastname: Zwischenberger
authors.forename: Joshua
authors.initials: J
authors.lastname: Sonett
authors.forename: Matthew
authors.initials: M
authors.lastname: Bacchetta
mesh_terms: D057785:Catheters; D017548:Echocardiography, Transesophageal; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D006801:Humans; D007601:Jugular Veins