VENOVENOUS DOUBLE-LUMEN CANULE TECHNIQUE IN ECMO

Extracorporal membrane oxygenation (ECMO) has been applied in more tha n 7600 neonates with PPHN-associated diseases after failure of maximum conventional treatment (overall survival rate: 81 %). A disadvantage of the mostly used veno-arterial ECMO technique is the - at least temp orary - occlusion of the right carotid artery. Therefore as an alterna tive modality the venovenous double-lumen canule ECMO technique has be en developed: hereby through a double-lumen canule (introduced into th e right jugular vein) blood is as well drained as reperfused after oxy genation into the right atrium. We report on the first 10 neonates, wh o have been treated with VV-DL-ECMO at the Universitats-Kinder-klinik Mannheim, Germany. All patients suffered from severe pulmonary hyperte nsion due to MAS (n = 7), primary persistance of pulmonary hypertensio n (PPHN) (n = 1), sepsis (n = 1) and CDH (n = 1). In 9 children the re spiratory failure could be overcome after application of VV-DL-ECMO (d uration 33-127 hours). Extubation was possible some days later. We con clude that VV-DL-ECMO can be a successful therapy in newborns with sev ere, but reversible pulmonary diseases which cannot be treated by conv entional means.