Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy.

Creator(s)

Nelimar Cruz-Centeno, Children's Mercy Kansas City
Shai Stewart, Children's Mercy Kansas City
Derek R. Marlor, Children's Mercy Kansas City
Douglas C. Rivard, Children's Mercy HospitalFollow
John M. Daniel IV, Children's Mercy Kansas CityFollow
Tolulope A. Oyetunji MD MPH, Children's Mercy Kansas CityFollow
Richard J. Hendrickson, Children's Mercy HospitalFollow

Document Type

Article

Publication Date

2-2024

Identifier

DOI: 10.1177/00031348231198119

Abstract

BACKGROUND: Pediatric patients requiring extracorporeal membrane oxygenation (ECMO) may require renal replacement therapy even after decannulation. However, data regarding transition from ECMO cannulation to a hemodialysis catheter in pediatric patients is not currently available.

METHODS: Patientschildren's center from January 2011 to September 2022 were identified. Data was collected from the electronic medical record.

RESULTS: A total of 10 patients were included. The cohort was predominantly male (80.0%, n = 8) with a median age of 1 day (IQR 1.0, 24.0). All ECMO cannulations were veno-arterial in the right common carotid artery and internal jugular vein. The median time on ECMO was 8.5 days (IQR 6.0, 15.0). One patient had the venous cannula exchanged for a tunneled hemodialysis catheter during decannulation, two were transitioned to peritoneal dialysis, and seven had the temporary hemodialysis catheter converted to a tunneled catheter by Interventional Radiology (when permanent access was required) at a median time of 10 days (IQR 8.0, 12.5). Of these 7 patients, 28.6% (n = 2) developed catheter-associated infection within 30 days of replacement, with one requiring catheter replacement. Transient bloodstream infection occurred in 10.0% (n = 1) within 30 days of ECMO cannula exchange.

CONCLUSION: Venous ECMO cannula exchange for a hemodialysis catheter in children requiring renal replacement therapy after decannulation is possible as a bridge to a permanent hemodialysis or peritoneal catheter if renal function does not recover, while supporting vein preservation.

Journal Title

The American surgeon

Volume

90

Issue

2

First Page

216

Last Page

219

MeSH Keywords

Humans; Male; Child; Adolescent; Female; Cannula; Extracorporeal Membrane Oxygenation; Retrospective Studies; Catheterization; Renal Dialysis

Keywords

cannulation; catheter; extracorporeal membrane oxygenation; hemodialysis; outcomes; vein

Recommended Citation

Cruz-Centeno N, Stewart S, Marlor DR, et al. Exchange of Extracorporeal Membrane Oxygenation Cannulas for Hemodialysis Catheters in Children Requiring Renal Replacement Therapy. Am Surg. 2024;90(2):216-219. doi:10.1177/00031348231198119