title: Safe ECMO femoral decannulation by placement of inferior vena cava filter via internal jugular vein.
abstract: Veno-arterial extracorporeal membrane oxygenation (ECMO) is a lifesaving treatment in patients with cardiogenic shock or cardiac arrest caused by massive pulmonary embolism. In these patients, positioning an inferior vena cava filter is often advisable, especially if deep venous thrombosis is not resolved at the time of the ECMO suspension. Moreover, in ECMO patients, a high incidence of deep venous thrombosis at the site of venous cannulation has been reported, and massive pulmonary embolism following ECMO decannulation has been described. Nonetheless, an inferior vena cava filter cannot be positioned as long as an ECMO cannula is inside the inferior vena cava. Thus, we developed a strategy to allow placement of an inferior vena cava filter through the internal jugular concurrently with the removal of the femoral venous ECMO cannula. In two women supported by veno-arterial ECMO for cardiac arrest secondary to pulmonary embolism, this novel approach allowed for safe ECMO decannulation.
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy. castagnaluigi1983@gmail.com.
authors.forename: Luigi
authors.initials: L
authors.lastname: Castagna
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Maggioni
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Coppo
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Cortinovis
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Meroni
authors.affiliation: School of Medicine and Surgery, University of Milan-Bicocca, Via Cadore 48, Monza (MB), 20900, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Sosio
authors.affiliation: Department of Radiology, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Vacirca
authors.affiliation: Department of Radiology, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Leni
authors.affiliation: Department of Anesthesia and Intensive Care, San Gerardo Hospital, Via Pergolesi 33, Monza (MB), 20900, Italy.
authors.forename: Leonello
authors.initials: L
authors.lastname: Avalli
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods; D020878:Device Removal / Q000379:methods*; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D006323:Heart Arrest / Q000209:etiology / Q000601:surgery*; D006801:Humans; D007601:Jugular Veins / Q000601:surgery*; D011655:Pulmonary Embolism / Q000150:complications / Q000601:surgery*; D012121:Respiration, Artificial; D016306:Vena Cava Filters; D014682:Vena Cava, Inferior / Q000601:surgery*
keywords: Extracorporeal membrane oxygenation; Pulmonary embolism; Vena cava filter; Venous thromboembolism