Division of Pediatric Cardiac Surgery, Seattle Children's Hospital, Seattle, Washington 98105-0371, USA.
ASAIO J. 2013 Jan-Feb;59(1):81-5. doi: 10.1097/MAT.0b013e31827b519c.
Improved dual-lumen catheter design has resulted in greater efficiency of gas exchange during extracorporeal life support. However, standard venovenous (S-VV) catheters are prone to structural deformation that reduces flow capacity. Wire-reinforced dual-lumen catheters have recently been introduced to reduce the risk of structural deformation. A retrospective review was performed on 25 neonates and infants who received venovenous extracorporeal life support (ECLS) to evaluate the occurrence and nature of catheter-related complications and events related to interrupted ECLS. Comparisons were made between patients supported with wire-reinforced and non-wire-reinforced dual-lumen catheters. No significant difference in number of catheter-related complications or flow-interruption events was observed. The use of wire-reinforced catheters appeared to increase the risk of cardiac perforation whereas non-wire-reinforced catheters appeared to be more prone to early failure. Once support was established, interruptions of extracorporeal flow occurred with the same frequency during the initial 72 hours, regardless of the type of catheter used. Further improvements in dual-lumen VV catheter design may reduce the risk of failure and injury and improve efficiency of extracorporeal gas exchange.
改良的双腔导管设计提高了体外生命支持期间气体交换的效率。然而，标准的静脉-静脉（S-VV）导管容易发生结构变形，从而降低流量能力。最近引入了带钢丝增强的双腔导管，以降低结构变形的风险。对 25 名接受静脉-静脉体外生命支持（ECLS）的新生儿和婴儿进行了回顾性研究，以评估导管相关并发症的发生和性质，以及与 ECLS 中断相关的事件。对使用带钢丝增强和不带钢丝增强的双腔导管的患者进行了比较。导管相关并发症或流量中断事件的数量没有显著差异。使用带钢丝增强的导管似乎增加了心脏穿孔的风险，而不带钢丝增强的导管似乎更容易早期失效。一旦建立支持，在最初的 72 小时内，无论使用哪种导管，体外血流中断的频率相同。进一步改进双腔 VV 导管设计可能会降低故障和损伤的风险，并提高体外气体交换效率。
