Central line (CVL) placement at ECMO decannulation | 67 PATIENTS | successfully decannulated from ECMO | divided into two age groups: | ≤ 28-days | > 28-days | 4 years | Single-institution retrospective study of patients undergoing open neck decannulation. | 20 patients (31%) had a CVL placed at the time of decannulation. | Most common indications for ECMO | Sepsis and pneumonia - Patients older than 28 days | Congenital Diaphragmatic Hernia - Neonates | Most common indications for CVL | 45% hemodialysis | 25% monitoring | 25% access | At the time of decannulation: | 40% of the patients who didn't receive CVL required one in the first 30 days. | Conclusion: | Decannulation presents an opportunity to safely place an essential CVL. | https://pubmed.ncbi.nlm.nih.gov/33762118/ | Source: Rubalcava NS et al. Department of Surgery, University of Michigan, Ann Arbor | @StayCurrentMD | @EmTombash @emencisco @RodGerardo
Central line placement at ECMO decannulation: A missed opportunity
Infographic · Jan 2022 · 1 min read
In brief
In brief
Single-center study of 65 pediatric ECMO patients found that while only 31% received central venous lines at decannulation, 40% of those without lines required one within 30 days. Lines placed at decannulation showed high functionality (85%) with no infectious complications, suggesting decannulation represents an underutilized opportunity for safe central access placement.
- 69% of pediatric ECMO patients did not receive a CVL at decannulation, yet 40% required one within 30 days—representing a missed opportunity.
- CVLs placed at decannulation had 85% functionality at removal/death with zero infectious complications, demonstrating safety of placement.
- Neonates primarily needed access lines (89%), while older children required hemodialysis catheters (73%) with median CRRT duration of 20 days.
- Decannulation provides a safe window for CVL placement when vascular access is already established and infection risk may be lower.
- Proactive CVL placement at decannulation could reduce subsequent procedures and improve post-ECMO care continuity.
Written by the GCMD Library team from the infographic.
The infographic uses a teal and yellow color scheme with icons including a calendar, baby illustration, and anatomical diagram showing CVL placement. Data is presented in sections with percentages displayed in large yellow text against dark backgrounds. The layout flows from study details at top through indications and statistics to conclusion at bottom.
Introduction: ECMO is a support modality for refractory critical illness. This study reviews the incidence and utility of central venous line (CVL) placement at pediatric ECMO decannulation. Methods: A single-institution retrospective study of patients undergoing open neck decannulation from 2015 to 2019. Patients were divided into two groups: ≤ 28-days and > 28-days.
Results: Of 65 patients, 31% had a CVL placed at decannulation. Sepsis and pneumonia were the most common indications for ECMO in the older-group compared to CDH in neonates. The most common in- dications for CVL were hemodialysis (45%), monitoring (25%), and access (25%). 89% of neonates had an access line placed, whereas 73% of the older group received hemodialysis catheters. Median CRRT re- quirement was 20 days. 85% of lines were functional at time of removal or death. None were removed for infection. 40% of the patients not receiving a CVL at decannulation required one within 30 days. Conclusion: 69% of patients did not have a CVL placed at decannulation, however 40% required a CVL within 30 days. Most lines placed at decannulation remained functional and none were removed for infection. Decannulation removes the circuit as a route for vascular access, but it also presents an oppor- tunity to safely place an essential CVL.