Comparison of Wire-Reinforced and Non–Wire-Reinforced Dual-Lumen Catheters for Venovenous ECMO in Neonates and Infants

Abstract

Improved dual-lumen catheter design has resulted in greater efficiency of gas exchange during extracorporeal life support. However, standard venovenous (S-VV) catheters are prone to structural deformation that reduces flow capacity. Wire-reinforced dual-lumen catheters have recently been introduced to reduce the risk of structural deformation. A retrospective review was performed on 25 neonates and infants who received venovenous extracorporeal life support (ECLS) to evaluate the occurrence and nature of catheter-related complications and events related to interrupted ECLS. Comparisons were made between patients supported with wire-reinforced and non-wire-reinforced dual-lumen catheters. No significant difference in number of catheter-related complications or flow-interruption events was observed. The use of wire-reinforced catheters appeared to increase the risk of cardiac perforation whereas non-wire-reinforced catheters appeared to be more prone to early failure. Once support was established, interruptions of extracorporeal flow occurred with the same frequency during the initial 72 hours, regardless of the type of catheter used. Further improvements in dual-lumen VV catheter design may reduce the risk of failure and injury and improve efficiency of extracorporeal gas exchange.