Lüsebrink Enzo, Stremmel Christopher, Stark Konstantin, Petzold Tobias, Hein-Rothweiler Ralph, Scherer Clemens, Schüttler Dominik, Massberg Steffen, Orban Martin
Intensive Care Unit, Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.
Crit Care Explor. 2019 Jun 26;1(6):e0018. doi: 10.1097/CCE.0000000000000018. eCollection 2019 Jun.
Improvements in cannula removal techniques, and in particular a standardized decannulation technique with a suitable closure device, are needed to further improve patients' outcomes after percutaneous cannulation. The decannulation techniques described so far are neither sufficiently standardized nor proven enough to be used in the large group of venoarterial extracorporeal membrane oxygenation patients. To meet this challenge, we have established a highly standardized and safe decannulation technique based on the Perclose ProGlide closure system (Abbott Vascular, Lake Bluff, IL).
Establishment of a highly standardized and safe decannulation technique based on the Perclose ProGlide closure system, which is described in detail with comprehensive instructions for the executive clinician and first application in the context of a pilot study.
So far our technique has already been used successfully in seven patients since January 2019 as a standard procedure on our ICU with only one minor complication occurred after the first procedure, that is, a small pseudoaneurysm likely originating from antegrade perfusion puncture site which was sealed by thrombin injection.
Our crossed ProGlide technique using a hemostasis valve Y connector ensuring no blood loss seems to be a very promising decannulation technique.
需要改进插管拔除技术，特别是采用合适闭合装置的标准化拔管技术，以进一步改善经皮插管后患者的预后。迄今为止所描述的拔管技术既不够标准化，也没有足够的证据证明可用于大量静脉 - 动脉体外膜肺氧合患者。为应对这一挑战，我们基于Perclose ProGlide闭合系统（雅培血管，伊利诺伊州莱克布拉夫）建立了一种高度标准化且安全的拔管技术。
基于Perclose ProGlide闭合系统建立一种高度标准化且安全的拔管技术，并为执行临床医生提供详细说明以及在一项试点研究中首次应用的情况进行了详细描述。
自2019年1月以来，我们的技术已在7例患者中成功作为标准程序应用于我们的重症监护病房，首次操作后仅发生1例轻微并发症，即一个可能起源于顺行灌注穿刺部位的小假性动脉瘤，通过注射凝血酶得以封闭。
我们使用止血阀Y形连接器确保无失血的交叉ProGlide技术似乎是一种非常有前景的拔管技术。
