title: Experience with the Avalon® bicaval double-lumen veno-venous cannula for neonatal respiratory ECMO.
abstract: OBJECTIVE
  We report a single centre experience of neonatal respiratory ECMO using the Avalon® double-lumen venous cannula and compare it with reports in the literature.
  
  
  RESULTS
  Between 2008 and 2012, the Avalon® cannula was used in 72 neonates: median age at cannulation was 1.8 days (IQR 1.2-2.8 days) and bodyweight 3.4 Kg (3.0-3.7 Kg). Meconium aspiration syndrome (61.1%), persistent hypertension of the newborn (25%) and congenital diaphragmatic hernia (5.6%) were the most common diagnoses. Complications occurred in 19 patients (26.4%): cannula site bleeding in 6 (8.3%), the cannula perforating the right atrial wall and requiring emergency midline sternotomy in 5 (6.9%) and the cannula needing repositioning in 3 (4.2%). Overall survival at discharge or transfer to the referring hospital was 88.8%. Successful wean off ECMO occurred in 68 patients (94.4%) after a median of 90.5 hours (63.4-136.11). ECMO support was withdrawn in 4 patients (5.6%).
  
  
  CONCLUSIONS
  The Avalon® dual-lumen veno-venous cannula can be used for respiratory ECMO in the neonatal population. However, as the incidence of right atrial perforation is not negligible, we suspended its used in this group of patients.
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK simone.speggiorin@gmail.com.
authors: S
authors: S
authors: Speggiorin
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: S G
authors: SG
authors: Robinson
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: C
authors: C
authors: Harvey
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: C
authors: C
authors: Westrope
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: G M
authors: GM
authors: Faulkner
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: P
authors: P
authors: Kirkland
authors: Heartlink ECMO Centre, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Leicester, UK.
authors: G J
authors: GJ
authors: Peek
mesh_terms: D018572:Disease-Free Survival; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008471:Meconium Aspiration Syndrome / Q000401:mortality / Q000628:therapy*; D010547:Persistent Fetal Circulation Syndrome / Q000401:mortality / Q000628:therapy*; D012189:Retrospective Studies; D015996:Survival Rate; D062666:Vascular Access Devices
keywords: ECMO; cannula complication; complication; neonate; respiratory failure