Rapid Placement of Bicaval Dual-Lumen Catheter in a Swine Model of Venovenous ECMO

ABSTRACT

Background: Venovenous (VV) extracorporeal membrane oxygenation (ECMO) applied through a single site with a bicaval dual-lumen (BCDL) catheter is a growing method of treatment of acute respiratory failure, thus animal models for research purposes are needed. We describe a rapid technique for the placement of the BCDL catheter for single-site VV ECMO in swine. Design: Prior to the application of single-site VV ECMO model with common crossbred piglets, BCDL catheters were placed using anatomical landmarks. Transthoracic echocardiography (TTE) with color Doppler was used to determine catheter placement. Final determination of catheter placement was confirmed by necropsy. Arterial blood gas and hemodynamic parameters were recorded at baseline and then hourly. The values are mean ± SD. Results: Using anatomical landmarks by positioning the BCDL catheter tip approximately 6.5 cm distal to the tip of the manubrium, cannulation was easily accomplished in five piglets with no positional adjustments of the catheter required. Cannula placement was confirmed with both TTE color Doppler and necropsy. Respiratory support was achieved with baseline and hourly measurements of pH 7.45 ± 0.03, 7.44 ± 0.07, 7.46 ± 0.05, 7.47 ± 0.06 (p = NS); PO₂ 86 ± 30 mmHg, 98 ± 30 mmHg, 94 ± 40 mmHg, and 79 ± 30 mmHg (p = NS); and PCO₂ 43 ± 3 mmHg, 44 ± 8 mmHg, 38 ± 5 mmHg, and 40 ± 4 mmHg (p = NS). Conclusions: Using anatomical landmarks for the placement of the BCDL catheter was rapid and effective in a swine model of VV ECMO, resulting in improved time efficiency for research.

Keywords: :

• anatomical landmarks
• transthoracic echocardiography
• color Doppler
• extracorporeal membrane oxygenation
• single-venous
• swine
• venovenous