Initial experience with single-vessel cannulation for venovenous extracorporeal membrane oxygenation in pediatric respiratory failure

Pediatr Crit Care Med. 2013 May;14(4):366-73. doi: 10.1097/PCC.0b013e31828a70dc.


Objectives: Venovenous extracorporeal membrane oxygenation has been used to provide cardiopulmonary support in critically ill infants and children. Recently, dual-lumen venovenous extracorporeal membrane oxygenation has gained popularity in the pediatric population. Herein, we report our institutional experience using a bicaval dual-lumen catheter for pediatric venovenous extracorporeal membrane oxygenation support, which has been our unified approach for venovenous extracorporeal membrane oxygenation since 2009.

Design: This study is a retrospective review.

Setting: The setting is a tertiary children's hospital in a major metropolitan area.

Patients: Between 2009 and 2011, 11 patients were cannulated using a dual-lumen bicaval venous catheter. Patient demographics, cannulation details, circuit complications, complications of catheter use, and patient outcomes were collected from a retrospective chart review.

Interventions: None.

Measurements and main results: Eleven of the patients were cannulated for venovenous extracorporeal membrane oxygenation using the dual-lumen bicaval cannula. The median age at the time of venovenous cannulation was 1.9 years (range, 0.14-17.1), and the median weight was 10.2 kg (range, 3-84). Three patients (27%) required conversion to venoarterial extracorporeal membrane oxygenation. The median duration of extracorporeal membrane oxygenation support was 10 days (2-38 days). Fifty-five percent of patients suffered from a bleeding complication (disseminated intravascular coagulation, pulmonary hemorrhage, or intraventricular hemorrhage), and 45% had a circuit complication. Adequate flow rates were achieved in all patients. The overall hospital mortality in the series was 55%. There were no cannula-related complications.

Conclusions: This review presents the first single-institution experience with the dual-lumen Avalon cannula in pediatric patients. Preliminary results indicate that the catheter can be safely placed and has an acceptable complication profile; however, continued study within larger trials is necessary to fully ascertain the clinical profile of this catheter.

MeSH terms

  • Anticoagulants / adverse effects
  • Blood Coagulation Disorders / chemically induced
  • Catheter Obstruction
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / instrumentation*
  • Catheterization, Peripheral / methods
  • Extracorporeal Membrane Oxygenation / adverse effects
  • Extracorporeal Membrane Oxygenation / instrumentation*
  • Extracorporeal Membrane Oxygenation / methods
  • Hemorrhage / chemically induced*
  • Hospital Mortality
  • Humans
  • Infant
  • Lung Diseases / chemically induced*
  • Respiratory Insufficiency / physiopathology
  • Respiratory Insufficiency / therapy*
  • Retrospective Studies
  • Time Factors


  • Anticoagulants