Bedside Saline-Contrast Transthoracic Echocardiography Placement of Bicaval Dual-Lumen Catheter for Venovenous Extracorporeal Membrane Oxygenation

摘要

We report the initial successful use of saline-contrast transthoracic echocardiography (TTE) in the placement of bicaval dual-lumen (BCDL) catheter (Avalon Laboratories, LLC, Rancho Domi-nguez, CA) at the bedside for the administration of venovenous (VV) extracorporeal membrane oxygenation (ECMO). There are two common configurations of VV ECMO: single-site cannulation of the right internal jugular vein or two-site cannulation of the femoral and internal jugular veins. For single-site VV ECMO with the BCDL catheter, precise placement can be challenging but is a necessity to assure correct direction of the reinfusion jet toward the tricuspid valve. Consequently, BCDL catheter placement is often done with radiographic visualization with fluoroscopy and transesophageal echocardiography (TEE) (1,2). Recent evidence found that transthoracic echocardiography is limited in assessing BCDL catheter placement for single-site W ECMO (3).