Double lumen cannula for VV ECMO

The double lumen cannula enables veno-venous extracorporeal membrane oxygenation (VV ECMO) to patients with severe respiratory failure. It is often used as a bridge to lung transplant.

The cannulation is usually performed via the right jugular vein. This position allows the patients to stay awake and move around with the mobile ECMO system.

The cannula consists of two lumens. One lumen allows extraction of deoxygenated blood from the distal and proximal ports from the inferior and superior vena cava, while the other lumen allows the oxygenated blood to return from the external oxygenator to the right atrium.

The cannulation with double lumen cannula should be performed with fluoroscopic guidance. When the cannula passes the right atrium, it is associated with risks of malpositioning of the cannula and right ventricular perforation. Cannulation may be performed with transesophageal echocardiography.

Complications

• malpositioning of the cannula
• right ventricular perforation
• thrombosis around the cannula
• clotting
• bleeding