SINGLE NEEDLE VENOVENOUS EXTRACORPOREAL MEMBRANE-OXYGENATION USING A NONOCCLUSIVE ROLLER-PUMP FOR RESCUE IN INFANTS AND CHILDREN

In 1993, J.Y. Chevalier described a single needle venovenous extracorp oreal membrane oxygenation (ECMO) system using a nonocclusive roller p ump and alternating clamps for pulmonary support in neonates. We modif ied this system to use it in older children as well and for additional indications. Introducing a double raceway and 2 different sizes of tu bing sets and performing percutaneous approach, we treated 21 children (age 1 day to 49 months) using this system. Indications for treatment were hypoxia and hypoxic induced myocardial dysfunction resulting fro m pulmonary failure, sepsis, and congenital defects. Of the children t reated for neonatal indications, 7/9 survived. For 2 children ECMO was terminated because of intraventricular hemorrhage (IVH). In the pedia tric group 5/7 of the children could be weaned from ECMO, and 2 childr en died after more than 30 days on ECMO. Two of the children who had b een almost completely weaned died later because of therapy withdrawal following a brain death diagnosis. In the cardiac group, 3/5 of the ch ildren survived. We conclude that the described system is an effective -venovenous ECMO system that reduces invasivity and expenditure.