Early Use Experience of the Crescent Right Atrial Cannula for Neonatal Veno-Venous Extracorporeal Membrane Oxygenation

Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is associated with fewer neurological complications and decreased mortality compared to veno-arterial (VA) ECMO in neonatal respiratory failure. The Crescent right atrial (RA) cannula is the only dual-lumen cannula for neonatal VV ECMO designed to have the tip in the right atrium. The purpose of this study is to describe the experience with early use of the Crescent RA cannula. We performed a retrospective cohort study of 58 neonates and infants cannulated from September 2021 through August 2023 at 15 institutions represented within the Children's Hospital Neonatal Consortium (CHNC) ECMO Focus Group. Members provided information on patient characteristics, ECMO runs, complications, and outcomes. Data were analyzed with descriptive statistics. Imaging was used during cannulation in 79.3% of cases. Survival to discharge was 84.5%. There was one major cannula-related complication resulting in death. The most common complication was cannula malposition in 46.6% of patients, requiring surgical repositioning in 29.3% of the total cohort. Early use experience with the Crescent RA cannula suggests that it is effective and safe in most patients, but the cannula may require repositioning to achieve optimal ECMO support or if malpositioned. Based on these observations, we developed recommendations for cannulation and cannula surveillance.

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Publication Details

Journal
ASAIO Journal
Published
2025-01-16
DOI
https://doi.org/10.1097/mat.0000000000002371
Citations
4
Primary Topic
Mechanical Circulatory Support Devices
Type
article
Field-Weighted Citation Impact
2.70
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article

Early Use Experience of the Crescent Right Atrial Cannula for Neonatal Veno-Venous Extracorporeal Membrane Oxygenation

Annie Chi, Robert DiGeronimo, Denise Suttner, Shannon E. G. Hamrick et al.
4 citations
ASAIO Journal
Mechanical Circulatory Support Devices
2.70
article

Early Use Experience of the Crescent Right Atrial Cannula for Neonatal Veno-Venous Extracorporeal Membrane Oxygenation

Annie Chi, Robert DiGeronimo, Denise Suttner, Shannon E. G. Hamrick, Allison F. Linden, Natalie E. Rintoul, Mark F. Weems, Rachel Chapman, Ricardo J. Rodríguez, Nicholas Carr, Patrick Sloan, Vedanta Dariya, Michael Sobolic, Leslie Lusk, Franscesca Miquel‐Verges, Ogechukwu Menkiti, Brian W. Gray, Sharada Hiranya Gowda, Caraciolo J. Fernandes, Goeto Dantes, Swosti Joshi, Rakesh Rao, Sarah Keene, Ruth Seabrook, Vilmaris Quiñones Cardona, Daniel R. Dirnberger, Abhishek Makkar, Yujin Park
article en
4 citations

Abstract

Veno-venous (VV) extracorporeal membrane oxygenation (ECMO) is associated with fewer neurological complications and decreased mortality compared to veno-arterial (VA) ECMO in neonatal respiratory failure. The Crescent right atrial (RA) cannula is the only dual-lumen cannula for neonatal VV ECMO designed to have the tip in the right atrium. The purpose of this study is to describe the experience with early use of the Crescent RA cannula. We performed a retrospective cohort study of 58 neonates and infants cannulated from September 2021 through August 2023 at 15 institutions represented within the Children's Hospital Neonatal Consortium (CHNC) ECMO Focus Group. Members provided information on patient characteristics, ECMO runs, complications, and outcomes. Data were analyzed with descriptive statistics. Imaging was used during cannulation in 79.3% of cases. Survival to discharge was 84.5%. There was one major cannula-related complication resulting in death. The most common complication was cannula malposition in 46.6% of patients, requiring surgical repositioning in 29.3% of the total cohort. Early use experience with the Crescent RA cannula suggests that it is effective and safe in most patients, but the cannula may require repositioning to achieve optimal ECMO support or if malpositioned. Based on these observations, we developed recommendations for cannulation and cannula surveillance.

ASAIO JournalVol. 71(8)
University of Southern California (US), Seattle Children's Hospital (US), Arkansas Children's Hospital (US), Apple (Israel) (IL), Nationwide Children's Hospital (US), St. Louis Children's Hospital (US), Primary Children's Hospital (US), Alfred I. duPont Hospital for Children (US), Children's Hospital of Philadelphia (US), Children's Hospital of Los Angeles (US), Emory University (US), University of California, San Francisco (US), Baylor College of Medicine (US), University of Washington (US), Washington University in St. Louis (US), University of Utah (US), Community Health Systems - Dupont Hospital (US), Ider University (MN), University of California San Diego (US), Rady Children's Hospital-San Diego (US), Cook Children's Medical Center (US), UCSF Benioff Children's Hospital (US), Children's Healthcare of Atlanta (US), Brenner Children's Hospital (US), Texas Children's Hospital (US), Le Bonheur Children's Hospital (US), St. Christopher's Hospital for Children (US), Indiana University School of Medicine, Wake Forest University (US), The Ohio State University (US), Indiana University – Purdue University Indianapolis (US), Drexel University (US), University of Tennessee at Knoxville (US), University of Pennsylvania (US), University of Arkansas for Medical Sciences (US), The University of Texas Southwestern Medical Center (US)
Good health and well-being
Openalex Percentile: Top 12%
Mechanical Circulatory Support Devices
2.70
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